Transplante médula osea Flashcards
Hepatopoietic cell transplantation (HCT) is an advanced therapeutic intervention that is required for a number of malignant and nonmalignant medical conditions.
This procedure typically involves the administration of … followed by … procured from a donor.
- high-dose chemotherapy
- infusion of hematopoietic stem cells
BONE MARROW MICROENVIRONMENT
… (4)
- Multipotent CD34+ cells
- Different types of cells
- Growth factors
- Chemokines
GOALS OF HCT
To reconstitute a patient’s hematopoietic and immune system by delivering the appropiate amount and type of stem cells.
Generate … effect.
To replace or rectify an underlying deficiency.
anti-malignancy
WHERE DO STEM CElLS COME FROM?
1. … : Capable of developing a complete organism. Zygote, early embryo
2. … : Form cells of all germ layers. Early embryo and blastocyte stage
3. … : Seen in specific lineage and found in umbilical cord, fetal and somatic tissue. Hematopoietic, mesenchymal, neuronal
- Totipotent
- Pluripotent
- Multipotent
COMMON HCT INDICATIONS
Non-malignant
(3) …
- Aplastic anemia
- Hemoglobinopathies
- Bone marrow failure syndromes
¿What are 7 COMMON HCT INDICATIONS?
- Malignant disease
- Leukemia
- Lymphoma
- Myeloma
- Hodgkin’s and NH disease
- Myelodisplastic
- Solid tumors
COMMON …
Immunodeficiencies
Autoimmune disease
Inborn error of metabolism
Other
HCT INDICATIONS
HCT PATHWAY
- Planning requires multidisciplinary approach to patient management.
Factors including … (4) need to be considered before decisions regarding the type of transplantation to be performed and medications to be used.
- patient age
- performance status
- underlying disease
- previous complications and donor selection
HCT PATHWAY
1- Identify: Disease indication, Best donor, Type of transplant, Stem cell source
2- Chemotherapy administration (…), Stem cell procurement (…)
3- … , Hepatopoietic and immune reconstitution
- patient
- donor
- Stem cell infusion
STEM CELL SOURCES
… (2)
- Bone marrow
- Peripheral blood
BONE MARROW
1) Soft, sponge-like tissue inside of bones
2) Collected by bone marrow harvest (multiple aspirations of …)
posterior iliac crest
BONE MARROW
3) Collection goal … /kg cells (… L max)
4) Less graft versus … (not needed in non-malignant disease)
- 2-4 x 10^8
- 1.5
- leukemia effect
PERIPHERAL BLOOD
1) …% concentration in comparison of bone marrow
2) Requires … and mobilization with medications (…)
- 1
- bone marrow stimulation
- filgrastim
PERIPHERAL BLOOD
3) Collection goal …/kg cells (… L max)
4) Most commonly used / preferred graft source for …
- 2-6 × 10°6
- 1.5
- malignant disease
CORD BLOOD
1) Cells are located in the …
2) Collection at time of delivery of a healthy baby
3) Collection goal … /kg cells (… mL)
4) Needs cryopreservation
- placenta
- 2.5-3 x 10^7
- 20-150
