Bone Marrow Transplant

Question 1

How likely are siblings to be an exact match to each other

Answer 1

1/4

Question 2

5 stages of autologous transplant

Answer 2

1 - GF injection -> stim stem cell growth
2- CD34+ (stem cell marker) cells collected from BM/ periph blood
3 - conditioning Tx (high dose chemo)
4 -re-infuse stem cells
5 - immune reconstitution

Question 3

Timeline for acute GVHD

Answer 3

normally 2-3w after

but anything <100 days

Question 4

Pathology of acute GVHD

Answer 4

conditioning Tx -> tissue damage -> APC activation -> donor T cell activation -> cellular / inflam markers

Question 5

3 main organs affected in acute GVHD

Answer 5

skin - rash
liver - jaundice + hep
gut - diarrhoea

Question 6

occurance of chronic GVHD

Answer 6

affects 50%

attack all organs

Question 7

RF for GVHD

Answer 7

inc HLA disparity
intense conditioning
inc age
F donor (esp multiparous) to male pt

Question 8

Tx for GVHD

Answer 8

corticosteroids

+/- ciclosporin a (calcineurin inhib)

Question 9

prevention of GVHD

Answer 9

anyone getting a transplant given:
corticosteroids (methotrexate)
+ ciclosporin/tacrolimus