Haematology 15: Bone Marrow Transplantation Flashcards
What happens in Autologous stem cell transplantation ?
- Growth factor is given to promote stem cell proliferation
- Stem cells (CD34+) are collected from the bone marrow and frozen
- The patients receives an intensive chemotherapy regime to wipe out the bone marrow including the cancer cells
- The collected stem cells are thawed and re infused into the patient
- A new immune system is established
Give 3 examples of diseases for which Autologous stem cell transplant could be used ?
Myeloma
Lymphoma
CLL
list resistance to radiation least to most
sublinical
BM
GI
CNS
what is a marker of stem cells
CD34
what happens in allogenic transplantation
high dose chemoradiotherapy
ablates the bone marrow
give BM from a healthy donor
what is allogenic transplantation suitable for
acute leukaemia chronic leukaemia myeloma lymphoma BM failure congenital immune deficiencies
what 3 methods can be used to harvest SC
bone marrow sampling - pelvis
peripheral blood sampling - G-CSF given to stimulate granulocyte production
umbilical cord blood
what does the success of transplant depend on
the number of CD34 cells per kg of weight in the recipient
list 4 complications of SC transplant
Graft failure
infections
GVHD
relapse
what factors affect the outcome of transplant
age disease phase gender of R/T - F- M is higher time to BMT donor - sib = 0 , VUD = 1
what infections are common following SC transplant
aspergillosis
CMV
what is GVHD
an immune response where donor cells recognise the patient as foreign
acute affects - skin, GI, liver
chronic affects - skin, mm, lungs, liver, eyes, joints
how can we treat GvHD
corticosteroids cyclosporin A FK506 mycophenolate mofetil monoclonal antibodies photophoresis total lymphoid irradiation
how can we prevent GvHD
methotrexate corticosteroids cyclosporin A + methotrexate FK506 T cell depletion post-transplant cyclophosphamide
