BMTCN STUDY GUIDE QUESTIONS AND ANSWERS

erythrocyte, platelets, neutrophil, basophil, eosinophil, monoblast, macrophage, monocyte Myeloid pre- B cell, pre-t cell, plasma cell, natural killer cell, t lymphocyte lymphoid occurs naturally- phagocytes release inflammatory mediators innate immunity response of either b or t cells to antigens acquired immunity loss of cells power to divide and grow senescence reduction in size of thymus and function of immune cells immunosenescence myeloid first responders lymphoid- pathogen specific second responders identical twin, don't need immunosuppression, con- no graft vs tumor effect syngeneic -promoted by withdrawal of immunosuppressant therapy -promoted by DLIs -dec. in absence of acute gvhd -higher rate of relapse graft vs. tumor effect infusion of lymphocytes from donor given when there is relapsed disease. Attempt to create GVT effect DLI - 70 %, - faster engraftment, no anesthesia risks, dec. likelihood of contamination by tumor, -higher risk of gvhd, - but better gvt effect- so dosent make sense for SCD PBSCT filgrastim. a glycoprotein stimulates the production of stem cells by binding to certain cell surface areas G-CSF sargramostim. lower stem cell yields. and inc adverse events. similar mechanism of action GM-CSF chemo causes reduction in production of blood cells thus stimulating hematapoetic recovery. -cyclophosphamide -paclitaxel -etoposide -cytarabine -improved mobilization -more rapid engraftment -reduced risk of tumor cell contamination chemo induced mobilization directly induce mobilization by working as antagonist between the chemokine stromal-derived-factor- 1 and receptor CXCR4. -Plerixafor -often in combination with GCSF chemokine antagonist mobilization produces stem cells that create rbcs, whit bcs, and plts. found in long and flat bones red bone marrow produce stromal stem cells that produce fat, cartilage and bone. found in long bones yellow bone marrow long bones in childhood. axial skeleton in adulthood where are hematopoitic stem cells produced? forms t cells. located in mediastinum. thymus gland filters white cells and plts spleen engraftment of neutrophils and plts faster, procedure can be done outpatient, increased immunologic function compared to bone marrow , early regimen related toxicity decreased. con- source contains more cd34 cells than bone marrow, inc. risk for chronic gvhd peripheral blood stem cells dec risk of gvhd. but longer engraftment bone marrow stem cells lower risk of gvhd. dec. viral disease transmission, CONS- limited number, slowest engraftment, delayed immune reconstitution, dec, GVT effect, inc risk of graft failure, cost ubc stem cells late 1960s for luekemia first allogenic transplant tissue typing to evaluate the HLA match bw donor and recipent histocompatibility testing glycoprotein on the surface of cells located on chromosome 6-play a major role in the immune system's ability to recognize self vs. non-self. HLA not imperative. RBCs can be filtered out to prevent RBC lysis after infusion. after transplant recipent will seroconvert to donors blood type. ABO blood type compatibility Young large male. larger size better. # of pregnancies inc. risk of GVHD. Donor ideals under 18 need consent of parent. but may sign assent form. Consent-children number attained is measurement of procurements success. is a protein on stem cells. cd 34+ 1-2 L marrow volume collected hypocalcemia-sodium citrate binds to ionized calcium=fatigue, chills, tingling lips and extremities, dizziness. other side effects- hypovolemia, chills, HA symptoms during apheresis eradicate residual disease, provide immunosuppression- preventing graft rejection. goal of prep regimen dx in which an autoimmune rxn occurs, leaving bone marrow empty and unable to produce normal cells SAA rejection of donor cells. ATG dec. risk SAA biggest challenge chemokine Antagonist. mobilizes stem cells in patients with non-Hodgkin lymphoma and multiple myeloma. given in conjunction with GCSF. Plerixafor 5x10^6 CD34+ per kg goal # of stem cells usually peripheral IV, if not apheresis line in jugular vein IV access for donors 200-250 ml/kg donor collection in kids cryopreservation the maturity of the t cells determines how likely GVHd is to occur. the more t cells present the less likely the graft is to fail. peripheral blood has the most mature. UCB has the least. T- cells