Stem Cell Therapy

Question 1

Stem cell marker for hematopoietic stem cells

Answer 1

CD34

Question 2

List sources of hematopoietic stem cells for transplantation

Answer 2

• BM
• PB progenitor cells
• Cord blood

Question 3

3 types of stem cell transplants

Answer 3

• Autologous
• Allogeneic
• Syngeneic

Question 4

If a patient serves as their own donor, this would be a ____ stem cell transplant

Answer 4

Autologous

Question 5

If a volunteer donor provides stem cells for a recipient that is an HLA match, this would be a ____ stem cell transplant

Answer 5

Allogeneic

Question 6

If a patient’s identical twin were donate their stem cells, this would be a ____ stem cell transplant

Answer 6

Syngeneic

Question 7

List the diseases treatable w/ stem cell transplants

Answer 7

• Germ cell tumors
• Neuroblastoma
• Amyloidosis
• MDS
• Aplastic anemia

Question 8

Hematopoietic stem cell processing steps

Answer 8

• Flow cytometry
• Cryopreservation
• Concentration
• RBC depletion
• Thaw/wash
• Filtering
• Infusion of thawed HSCs

Question 9

Flow cytometry procedure

Answer 9

• Detects and enumerates stem cells
• Fluorescent tags product sample w/ anti-CD45 and anti-CD34 to determin stem cell content in HSC product
• Physician determines apheresis collection status

Question 10

Cryopreservation procedure

Answer 10

• Controlled rate freezer slowly cools cells to -90°C at a rate of 1°C/minute to prevent ice crystal formation
• Cryprotectant DMSO is used to maintain HSC viability
• Frozen cells are stored: vapor phase liquid nitrogen (LN2) freezer at < -150°C
• Able to store for up to 12 years

Question 11

Cell concentration procedure

Answer 11

Uses centrifugation to reduce volume by plasma depletion w/ minimal WBC loss

Question 12

RBC depletion procedure

Answer 12

Minimizes exposure to RBC for allogeneic recipients w/ ABO mismatch

Question 13

Thaw/Wash procedure

Answer 13

• Cells are thawed/washed; dextran 40 and 5% HSA (in the lab) to remove DMSO before infusion
• Routinely performed on cord bloods to minimize pediatric infusion reaction

Question 14

Filtering procedure

Answer 14

• Harvested BM is filtered to remove spicules and clots
• 1-3 bags are collected and pooled into 1 bag for transport
• Infused fresh

Question 15

Thawed HSC infusion procedure

Answer 15

• Performed at patient’s bedside
• Cells are transported from storage freezer to patient bedside via portable LN2 shipper
• Cells thawed in 40°C saline waterbath
• Cells infused immediately to minimize DMSO exposure and prevent cell death via central intravenous line
• Only saline is infused simultaneously

Question 16

List the typical reactions to stem cell infusions

Answer 16

• Chills
• Coughing
• Chest pain (tightness)
• Redness in face (flushing)
• Nausea and/or vomiting

Question 17

Primary method for determining success of a stem cell transplant

Answer 17

Engraftment

Question 18

What is the primary cause of the reactions to stem cell infusions?

Answer 18

Reaction to cryoprotectant DMSO adn resolve post infusion