Marrow Failure Flashcards
What is aplastic anemia?
body stops producing enough blood cells
what are the two major mechanisms of stem cell depletion?
1) autoimmune disease
2) DNA damage
allogenic stem cell transplant
use of stem cells from someone other than the patient
there are different tiers of allogenic stem cell transplants
autologus stem cell transplant
use of healthy stem cells from own patient to replace the unhealthy ones
pathophysiology of severe aplastic anemia
stem cells divide constantly
impairment of DNA replication / errors in DNA can lead to stem cell loss through APOPTOSIS
How can you tell if aplastic anemia is due to autoimmune disease or DNA damage? What do you do depending on results?
do a gene panel
if positive, do stem cell transplant since there is DNA damage
if negative, do immunosuppressant therapy since there is autoimmune disease
pancytopenia
decrease in all blood cell types
immediately think of leukemia
start IV antibiotics since person is susceptible to infection
What is tradeoff when reducing graft v host disease?
you increase the risk of graft failure when decreasing the risk of GvHD
How can body attack new organ after transplant?
recognizes the new MHC cells as other and attacks these MHC cells
Acute GvHD
within the first 100 days
chronic GvHD is anything after 100 days
Syngeneic transplant
type of allogenic transplant
use identical twin
matched sibling transplant
type of allogenic transplant
use a sibling with similar loci
How many loci do we want similar for transplant?
10 loci if possible
2 types of prep regimens for stem cell transplant
1) myeloablative – empty entire bone marrow (TBI)
2) immunosuppressants – target mature T-cells and leave granulocytes intact
unrelated donor
type of allogenic transplant
between 5-10 loci matched
donor is taken from a registry
