Transfusions and Bone Marrow Transplants

Question 1

aglutinin

Answer 1

• antibodies present in plasma of these patients are called ‘agglutinins’ because they agglutinate A or B expressing erythrocytes when exposed to them
• The production of anti-A or B agglutinins is probably due to exposure to similar antigens in the diet

Question 2

A Blood Group

Answer 2

anti-B antibodies present in plasma

Question 3

B Blood Group

Answer 3

anti-A antibodies present in plasma

Question 4

AB Blood group

Answer 4

No Abs present in plasma)

Question 5

O Blood Group

Answer 5

both anti A and anti B Abs present in
plasma

Question 6

Rh (-)

Answer 6

do not develop antibodies against Rh unless exposed massively to cells bearing this antigen (for example, in a transfusion)

Question 7

Erythroblastosis fetalis

Answer 7

• is a disease of the fetus and newborn where there is agglutination and phagocytosis of its red blood cells

• the mother is Rh (-) and the father is Rh(+) and therefore the fetus’ erythrocytes are also Rh(+)
• the mother’s anti-Rh antibodies (against D antigen of Rh) may diffuse to the fetus through the placenta and may cause red blood cell agglutination
• About 3% of second babies and 10% of third babies
  exhibit some degree of erythroblastosis fetalis

Question 8

Bone Marrow Transplant

Answer 8

-Offers the possibility of ‘correcting’ a defect in
hematopoiesis

-Can also be used to reconstitute a hematopoietic
system affected by cancer

Question 9

Graft vs Host Disease

Answer 9

T cells present in the grafted cells recognize their
host as ‘foreign’ and become activated
– They proliferate and produce cytokines
– Cause systemic symptoms of inflammation

• Many organs are affected including: liver, skin, mucosa

Question 10

MHC Class I

Answer 10

• Major Histocompatibilty Complex subset
• HLA-A, HLA-B, HLA-C
• Single chain molecules associated with β2 microglobulin

– Expressed in all cells of the body
– Used to ‘present’ antigen to CD8 “cytotoxic/killer” T cells to initiate a cytotoxic immune response

Question 11

MHC class II

Answer 11

• Two chain molecule, (α and β chains)
  – Expressed only by macrophages, dendritic cells, and B cells
  – Used to ‘present’ antigen to CD4 “helper” T cells to initiate an immune response

Question 12

Lymphopoiesis

Answer 12

-Lymphoid precursors originate in the bone marrow and migrate to the thymus -> CD4 or 8 Tcells

Question 13

chronic leukemia

Answer 13

slowly progressive, proliferating cells are partly or completely differentiated (myelocytes, metamyelocytes, neutrophils)

Question 14

acute leukemia

Answer 14

rapidly progressive, proliferating cells are undifferentiated (lymphoblasts)

Question 15

CCR5

Answer 15

portal of entry for HIV (also CXCR4)

Question 16

CCR7(+)

Answer 16

chemokine that directs migration of T cells home to the lymph nodes

Question 17

CXC

Answer 17

chemokines recruit neutrophils to inflammatory site

Question 18

CC

Answer 18

chemokines recruit monocytes and T cells to inflammatory sites

Question 19

Plerixafor

Answer 19

aka Mozobil

-A CXCR4 antagonist induces bone marrow stem
cell mobilization into the peripheral circulation (synergizes with G-CSF)

-This allows the collection of enough HSC from
the same patient that will receive the bone
marrow ‘transplant’ thus eliminated Graft vs Host concerns

– Approved for Lymphomas and Multiple Myeloma

Question 20

Adcetris

Answer 20

•Antibody drug conjugates:
•Combine an antibody with a cytotoxic drug
•Antibody binds a cell surface protein, then gets
internalized
•Inside the cell, the cytotoxic drug is released
•Drug kills the cell

approved for Hodgkin Lymphoma and anaplastic large cell lymphoma