Bone Marrow Transplant

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Author:
julieaburch
ID:
87704
Filename:
Bone Marrow Transplant
Updated:
2011-05-25 12:26:45
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Bone Marrow Transplant
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Description:
Bone Marrow Transplant
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  1. This is the IV infusion of hematopoietic stem cells (progenitor cells) to re-establish marrow function and reset immune function
    Bone Marrow Transplant
  2. What are the three sources of Blood Stem Cells?
    • Marrow
    • Peripheral Blood Stem Cells
    • Cord Blood Stem Cells
  3. How is a Bone Marrow Harvest Procedure done?
    • Under general anesthetic
    • Outpatient surgery
    • Multiple bone marrow aspirations done
  4. How are stem cells obtained from peripheral blood?
    • Daily injections of G-CSF
    • Large bore IV access
    • Pheresis
  5. How are stem cells obtained from Cord Blood?
    Taken from placental blood at birth
  6. This type of bone marrow transplant uses the patient's own cells
    Autologous
  7. This type of bone marrow transplant uses the patient's twin
    Syngenic
  8. This type of bone marrow transplant uses another person's bone marrow (sibling or unrelated donor)
    Allogenic
  9. What are the three most important antigens (HLAs or MHCs) for matching tissues?
    • A
    • B
    • DR
  10. Success in matching varies with population. Which populations have the best success? The worst?
    • Japanese (99%) and Caucasians (93%)
    • Asians & AAs (both at 50%)
  11. What is it called when the new immune system recognizes host tissue as "non-self"?

    This can be acute -- GI, skin, lung, hematologic most common (treat with steroids, immunosuppressant) -- or chronic: GI, liver, skin, lung, ocular (treatment: steroids, immunosuppressant, puva therapy, bcell directed therapy (rituximab)
    Graft versus Host Disease
  12. What is it called when the new immune system recognizes tumor as "non-self?"
    Graft versus Tumor Effect
  13. What are the pros associated with using cord blood stem cells?
    • Easily available
    • Additional source when no availability in NMDP registry
    • Likely CMV negative
    • Less GVHD
  14. What are the cons associated with using cord blood stem cells?
    • Engraftment time prolonged (often doubles)
    • Cell dose requires 2 units/adult
    • Can't obtain more cells
    • Unknown genetic disease transmission
  15. We perform this type of transplant in the following situations:
    -- Following initial chemo in high risk lymphoma patients that have not gone into remission
    -- Following chemo proving chemo-sensitive disease in relapsed lymphoma
    -- Multiple myeloma patients following intial therapy
    -- High risk lymphoma patients that are in remission that has a high likelihood of relapse
    Autologous Transplants
  16. We perform this type of transplant in the following situations:
    -- AML with high risk cytogenetics
    -- Treatment related AML
    -- AML induction failure
    -- High risk ALL (Ph+, CNS, Ind Failure, etc)
    -- MDS
    -- CML without remission with Imatinib
    Allogenic
  17. Wha is the average time to engraftment for peripheral blood stem cells? Marrow? Cord blood?
    • 15-18 days
    • 18-21 days
    • 28-40 days
  18. How is an Autologous Transplant performed?
    • Stem cells are collected from patient
    • Patient receives chemotherapy or radiation
    • Self-donated stem cells are re-infused into patient
  19. In Myeloablative Allogenic Transplants, what does the utility of transplant depend upon? How does this differ from Reduced-Intensity Allogenic Transplants?
    • Depends on cytotoxicity of chemo and graft versus tumor effect
    • Depends on graft versus tumor effect alone
  20. What disease has the highest indication for allogeneic blood and marrow transplantation worldwide? Second highest?
    • AML
    • ALL
  21. What type of transplants open up transplant to a greater population?
    Reduced Intensity Transplants

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