W12.2

Question 1

type of rejection for HSC transplant

Answer 1

GVHD

Question 2

HSC transplant is used for

Answer 2

Hematologic malignancies, immunodeficiencies, bone marrow failure

Question 3

Steps of HSC transplant

Answer 3

• For hematologic malignancies, immunodeficiencies, bone marrow failure
• Step 1. Wipe out prior immune system
• Step 2. Replace with donor bone marrow which gives rise to new blood cells including new (foreign) immune system

Question 4

GVHD

situation, Neg effect, occurance

Answer 4

• Donor mature T/NK cells may be present in bone marrow
• Negative effect: Foreign immune system can attack the entire host body
• Occurs first 100 days post-infusion and affects skin, GI tract, liver

Question 5

H. stem cells (transplantation antigen)

Answer 5

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Question 6

GVHD

positive effects

Answer 6

• GVHD can be harnessed in HSC transplants for leukemia treatment
• Graft-vs-leukemia effect helps eliminate residual recipient cancer hematopoietic cells
• T cells or NK cells mediate it

Question 7

Ways to improve transplant success

Answer 7

(Histocompatibility Lab Diagnostics)

• HLA typing
• Pre-formed anti-HLA antibody screening
• Recipient Abs to HLA Ags

Question 8

HLA typing

Answer 8

phenotypic or genotypic definition of the HLA antigens or genes in a transplant candidate and donor

Question 9

Pre-formed anti-HLA antibody screening

Answer 9

detecting pre-formed Abs in recipient that may cause hyperacute rejection

Question 10

CDC test

Answer 10

Complement-dependent cytotoxicity (CDC) test

• Classic procedure
• Requires defined antisera or mAbs to HLA antigens
• Limitations: viable Lymph. needed, antisera variations, limited resolution

Question 11

HLA genotyping

Answer 11

• Molecular method
• Amplification of gene by polymerase chain reaction (PCR) followed by analysis of DNA sequence
• overcomes CDC limitations

Question 12

Recipient Abs to HLA Ags

Answer 12

if Abs to donor present, that donor not further considered

Question 13

Recipient ABs to HLA Ags : CDC

Answer 13

• panels of lymphocytes with defined HLA phenotypes are incubated with the patient’s serum
• Percent panel reactive antibody (%PRA): % lymphocytes in the panel (out of 30–60) killed by the patient’s serum

Question 14

Recipient ABs to HLA Ags : ELISA

Answer 14

• substitute for CDC

- HLA-coated ELISA plates

Question 15

Recipient ABs to HLA Ags : Flow Cytometry

Answer 15

• Antibody in patient serum can be incubated with latex beads that are coated with HLA antigens, either from a single donor or a single purified HLA protein
• Patient serum is incubated with the beads, and bound antibody is detected by adding a FITC-labeled anti- IgG reagent
• Most sensitive assay

Question 16

Donor-recipient crossmatch test

Answer 16

• Used to confirm the absence of donor-specific antibody after candidate donor identified
• Donor lymphocytes are incubated with recipient serum in either
• a CDC assay
• Flow cytometry assay
• most sensitive method for detecting donor-specific antibody.

Question 17

Mixed lymphocyte reaction

Answer 17

• Lymphocytes from donor + lymphocytes from recipient
• Proliferation (indirect allorecognition)
• Cytotoxicity (direct allorecognition)

Question 18

CASE STUDY P33-37

Answer 18

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Question 19

Which of the categories of hypersensitivities involves a T-cell response?

Answer 19

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Question 20

Which of the categories of hypersensitivities is IgE-mediated?

Answer 20

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Question 21

Which of the following is not an autoimmune disease?

Answer 21

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Question 22

A positive tuberculin skin test is an example of what type of hypersensitivity reaction?

Answer 22

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Question 23

Erythroblastosis fetalis, also known as hemolytic disease of the newborn, most often occurs in ______________ mothers carrying ______________ fetuses.

Answer 23

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Question 24

Which part of the body is affected by lupus?

Answer 24

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Question 25

In what manner does a type III hypersensitivity reaction differ from a type II hypersensitivity reaction?

Answer 25

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