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Bone Marrow Transplantation
Terms in this set (14)
What is Autologous Transplant?
Patient's own marrow stem cells are harvested following G-CSF therapy and used to reconstitute bone marrow after intensive chemotherapy
What are some risks of autologous transplant?
Risk of reinfusing malignant cells
What are the indications for autologous transplants?
Some acute leukemias
What is Allogenic Transplant?
Patient bone marrow is replaced by donor stem cells, which are HLA-matched
Require HLA matching
Infections following transplant due to neutropenia and immunosuppressive therapy
Risk of reactivation of CMV/infection from donor
Indications for allogenic transplant
Sickle Cell Anemia
Chronic Myeloid Leukemia
What are some complications of Stem Cell Transplant?
Acute Graft vs Host Disease
What are the symptoms and signs of acute GVHD?
in 1st 100 days after transplant,
- Maculopapular rash
- Severe desquamation
- Nausea, vomiting
due to donor t cell activation by host APCs
What are some risk factors for GVHD?
High degree of HLA disparity (min. 4/6)
High Recipient age
Recipient/Donor gender: donor female to male recipient more likely
Signs and symptoms of chronic GVHD
Chronic liver disease
increased risk of infection
Treatment of GVHD
Anti-T cell Ab
What Infections will a patient be susceptible to?
- latent or from donor
- lymphocytes dedicated to keeping these latent are destroyed
- leads to reactivation
- more common in allogenic transplant
- fungal protection come much later
- Neutrophils develop earlier
- T cells produced midway through
- protection only come much later
Factors affecting outcome of transplant
Age: increased age, increased risk
Disease phase: later phase, increased risk
Gender: Female donor to male recipient intermediate risk
Time to BMT: <1 year ideal
Donor: Sibling is ideal
What is the Graft vs Leukemia Effect?
The T lymphocytes from donor exert an immune effect on tumour cells. T cell depleted BM leads to higher risk of relapse
THIS SET IS OFTEN IN FOLDERS WITH...
Myelodysplastic syndrome (MDS)
Adverse Transfusion Reactions
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