Week 12 Flashcards
List the 3 main sources of haematopoietic stem cells
- Peripheral blood
- Bone marrow
- Umbilical cord blood
Name the 3 TYPES of haematopoietic stem cells
AUTOLOGOUS
ALLOGENEIC
SYNGENEIC
AUTOLOGOUS
→ Self
ALLOGENEIC
→Genetically different donor
E.g. Sibling, Unrelated donor
SYNGENEIC
→ Identical twin donor
Peripheral blood stem cell (PBSC) collection in normally collected by _________.
apheresis
How do you increase Peripheral blood stem cell yield?
• Mobilise Peripheral blood stem cell with growth factors
What is an example of growth factors to increase Peripheral blood stem cell yield?
granulocyte colony stimulating factor (G-CSF)
Note: G-CSF increases number by 10 -100 times
List one example of an inhibitor of stem cell adhesion receptor
Plerixafor
How do you measure the yield of harvesting?
Yeild is assessed by CD34+ cell count
Note: it’s generally > 2 – 4 x 106/kg CD34+ cells needed
Name that cell:
is a transmembrane phosphoglycoprotein,
• first identified on hematopoietic stem and
progenitor cells
CD34+
What are the advantages of peripheral blood stem cell collection?
✓ Large volumes can be collected (higher than BM which mean shorter engraftment time)
✓ No anaesthesia required
What are the Limitations of peripheral blood stem cell collection?
▪ Requires apheresis equipment
▪ Greater incidence of GvHD for allogeneic transplant
Cord blood is rich in which cells?
Rich in potent haematopoietic progenitor cells
In cord blood stem cell transplant is the risk of GvHD is much lower or much higher?
Lower
o Greater number of HLA mismatches can be tolerated
Does cord blood have fewer or more haematopoietic progenitor cells than BM or PB harvest?
Fewer
Is cord blood more useful for children’s transplant?
Yes
Is the risk of risk of non-engraftment is higher or lower in cord blood transplants?
Higher
Hematopoietic stem cell antigen (used as a marker)
CD34+
In Autologous BMT (Mobilisation & Harvesting) What cells are collected or from where?
Patient’s own cells being collected
In Allogeneic BMT (Mobilisation & Harvesting) What cells are collected or from where?
Donor provides peripheral blood stem cells.
What are two types of Conditioning for Allogeneic transplants? Comment on age groups
Marrow ablative (MA) - mostly younger Reduced intensity conditioning (RIC) - can be used on older individuals
What is the key advantage and key risk for autologous stem cell transplants?
Advantage - No Graft vs Host Disease
Risk - Return of malignancy
What is the key advantage and key risk for allogeneic stem cell transplants?
Advantage - Graft vs malignancy effect
Risk - Graft vs Host Disease
Major determinants of complexity for stem cell transplant?
- Donor status (Related or unrelated)
- Source of stem cells (BM, PB, or Cord)
- Acuity of patient’s underlying disease
What are some early Complications of stem cell transplantation?
Infection
Haemorrhage
Acute pattern GvHD
Graft failure
What are some late Complications of stem cell transplantation?
Infection Chronic pattern GvHD Autoimmune disorders Cataract Infertility
What are some risk factors that can lead to GvHD?
• Patient age
• Disease stage
• Sex mismatch with donor
(Donor T-cells recognise antigens associated with Y chromosome)
Are infections more common in allogeneic or autologous?
Allogeneic
What is the most common infection for early phase and late phase allogeneic transplants?
Early - bacteria
Late - viral
In over 16yr olds is transfusion related mortality more common in autologous patients or identical sibling
identical sibling
Fpr acute leukaemias when is the transplant usually performed?
1st or 2nd remission
What is only potential curative treatment for MDS?
Allogeneic transplant
What is the standard of care for lymphoma in many instances?
Autologous transplant
HLA gene found on ______ arm of chromosome __.
short, 6
What is the HLA role?
Present peptides to T cells so that they can recognise & eliminate foreign or non-self particles
What does HLA stand for?
Human Leukocyte Antigen
Histocompatibility testing for transplantation:
Class I antigens:
Class II antigen:
Class I antigens: HLA-A, B, C
Class II antigen: HLA-DR and DQ
What administration regulates human tissue transplantation
Therapeutic Goods Administration (TGA)
