Bone marrow transplantation

Bone marrow transplantation

اسلاید 1: 4/3/20201Bone Marrow Transplantation

اسلاید 2: 4/3/20202IntroductionHematopoietic stem cell transplantation (HSCT)/the transplantation of multipotent hematopoietic stem cell or blood, usually derived from bone marrow, peripheral blood stem cells, or umbilical cord blood Stem cell transplantation is a medical procedure in the fields of hematology and oncology, most often performed for people with diseases of the blood, bone marrow, or certain cancers. The first bone marrow transplant was done in 1959 on five Yugoslavian nuclear workers whose own marrow had been damaged by irradiation, but all of these transplants were rejected.

اسلاید 3: 4/3/20203IndicationsIt was shown that bone marrow cells infused intravenously could repopulate the bone marrow and produce new blood cells. Indications/ Many recipients of HSCTs are multiple myeloma or leukemia patients who would not benefit from prolonged treatment with, or are already resistant to, chemotherapy. Other indications/ inborn defect such as severe combined immunodeficiency or congenital neutropenia with defective stem cells, aplastic anemia, sickle-cell disease, myelodysplastic syndrome, neuroblastoma, lymphoma, Ewings Sarcoma, … and Hodgkins disease..

اسلاید 4: 4/3/20204Graft TypesAutologous/ HSCT requires the extraction (apheresis) of haematopoietic stem cells (HSC) from the patient and storage of the harvested cells in a freezer. The patient is then treated with high-dose chemotherapy with or without radiotherapy with the intention of eradicating the patients malignant cell population at the cost of partial or complete bone marrow ablation (destruction of patients bone marrow function to grow new blood cells).

اسلاید 5: 4/3/20205Graft TypesAutologous/ The patients own stored stem cells are then returned to his/her body, where they replace destroyed tissue and resume the patients normal blood cell production. Autologous transplants have the advantage of lower risk of infection during the immune-compromised portion of the treatment since the recovery of immune function is rapid. Also, the incidence of patients experiencing rejection (graft-versus-host disease) is very rare due to the donor and recipient being the same individual.

اسلاید 6: 4/3/20206Graft TypesAutologous/ These advantages have established autologous HSCT as one of the standard second-line treatments for such diseases as lymphoma. Allogeneic/ HSCT involves two people: the (healthy) donor and the (patient) recipient. Allogeneic HSC donors must have a tissue (HLA) type that matches the recipient.

اسلاید 7: 4/3/20207Graft TypesAllogeneic/ Even if there is a good match at these critical alleles, the recipient will require immunosuppressive medications to mitigate graft-versus-host disease. Allogeneic transplant donors may be related (usually a closely HLA matched sibling), syngeneic (a monozygotic or identical twin of the patient) or unrelated (donor who is not related and found to have very close degree of HLA matching).

اسلاید 8: 4/3/20208Graft TypesAllogeneic/ Allogeneic transplants are also performed using umbilical cord blood as the source of stem cells. Race and ethnicity are known to play a major role in donor recruitment drives, as members of the same ethnic group are more likely to have matching genes, including the genes for HLA. 

اسلاید 9: 4/3/20209Sources of cells Bone marrow In the case of a bone marrow transplant, the HSC are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone. The technique is referred to as a bone marrow harvest and is performed under general anesthesia. Peripheral blood stem cellsPeripheral blood stem cells are now the most common source of stem cells for allogeneic HSCT. They are collected from the blood through a process known as apheresis. The donors blood is withdrawn through a sterile needle in one arm and passed through a machine that removes white blood cells. The red blood cells are returned to the donor.

اسلاید 10: 4/3/202010Sources of cellsPeripheral blood stem cellsThe peripheral stem cell yield is boosted with daily subcutaneous injections of Granulocyte-colony stimulating factor, serving to mobilize stem cells from the donors bone marrow into the peripheral circulation. Amniotic fluidIt is also possible to extract hematopoietic stem cells from amniotic fluid for both autologous or heterologous use at the time of childbirth. Umbilical cord bloodUmbilical cord blood is obtained when a mother donates her infants umbilical cord and placenta after birth.

اسلاید 11: 4/3/202011