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What are the cells called that are not actually stem cells but are more mature, commited to a particular cell line called?
Hematopoietic Progenitor cells
What are the requirements for HPC-M?
need 1L or more of marrow (that's a lot)
donor has to undergo gen anesthesia
What are the benefits of HPC-A?
faster engraftment and recovery(2 weeks)
less acute GVHD
no anesthesia needed
What are the benefits to using HPC-C?
rich in stem cells
can be harvested at time of delivery and stored
no donor risk
dec risk of HLA mismatch and GVHD
What are the 4 main reasons to use HPC tx?
2. immune def
3. inborn errors of metab
4. other: PNH, MS
What are the 3 types of HPC tx in patients?
1. allogeneic (donor and recipient are 2 diff people)
2. autologous (donor is recipient)
3. syngeneic (donor and recip are ident twins)
What is the amount of nucleated cells you want the recipient to get in an allogeneic harvest?
3 x 10^8 nucleated cells/kg
Why do you process the allog HPC specimen?
decrease # of RBC, plasma and T cells
isolate and purifiy CD34+ cells
What do you give HPC recipient prior to infusion of HPC?
blast BM with chemotx: cyclophosphamide most common
What is the term given to when grafted cells come in and destroy the remaining donor BM so you don't have to completely wipe out pt's BM?
Graft vs Tumor effect
What are the 5 complications of allogeneic HPC tx?
4. secondary cancers
What decreases risk of rejection in HPC tx? (2)
1. increase dose of HPC
2. use dose intense regimens
What secondary cancers are HPC tx recipients at risk for?
1. acute leukemia
2. oral SCC
3. thyroid, brain, bone, liver
What is a major ABO incompat?
Donor Ag incompat with Recipent ABO type
(ie give donor A to recip O) (it's a RBC Ag prob)
What is a minor ABO incompat?
Donor Ab incompat with Recip ABO Ag
(ie Donor O to A recip) (it's a plasma Ab prob)
What type of testing is done for HPC-C?
infxn dz testing done on mom
baby eval for infx or inherited dzs
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