Haematology 11 - BMT

Question 1

CD marker for stem cells

Answer 1

CD34

Question 2

Which body system is most resistant to radiation?

Answer 2

CNS

Question 3

Risk of dying from BMT

Answer 3

> 50%

Question 4

Probability of being 100% HLA matched

Answer 4

0%

Question 5

Outline the process of autologous SCT

Answer 5

GCSF given to obtain a CD34+ population of cells from BM (stem cells), these are preserved in teh freezer, irradiated with chemo and then reinfused in to the patient

Question 6

Which cancers is autologous SCT suitable for?

Answer 6

Acute leukaemias, solid tumours, autoimmune disease, myeloma, CLL, lymphoma

Question 7

Allogenic transplant process

Answer 7

Host’s BM irradiated then transplanted stem cells from a donor

Question 8

Allogenic transplant suitable for which diseases

Answer 8

Acute leukaemias, myeloma, CLL, lymphoma, congenital immune deficiencies, thalassaemia, SCD

Question 9

Serological vs DNA donor matching, difference in resolution

Answer 9

Serological = low resolution

DNA matching = high resolution

Question 10

3 different ways to harvest stem cells

Answer 10

Bone marrow sampling
Peripheral blood + GCSF
Umbilical cord

Question 11

Out of the 3 different ways to harvets stem cells, which yields the greatest volume of CD34+ Stem cells?

Answer 11

Peirpheral blood + G-CSF (umbilical cord the least hence only used in children which require low volumes)

Question 12

How many stem cells are required for a transplant?

Answer 12

2 million cD34+ stem cells/Kg recipient weight

Question 13

Score used to prognosticate outcome of BMT

Answer 13

EBMT score

Question 14

Factors affecting the outcome of the transplant

Answer 14

Age, R/D sex (make –> female higher risk), time to BMT (<1yr or >1 yr), Disease phase, Donor (sib or VUD)

Question 15

Which infection is the causative agent in 10-15% of transplant deaths?

Answer 15

ASPERGILLOSIS

Question 16

What is GvHD?

Answer 16

Donor cells recognise recipient cells as foreign

Question 17

Acute GvHD number of days post transplant vs chronic

Answer 17

<100, >100

Question 18

Effects of acute and chronic GvHD

Answer 18

Acute: Skin, GIT, liver
Chronic: similar to Sjrogen’s : skin, liver mucosal membranes dry, SOB, dry eyes , arthritis

Question 19

Pathophysiology of GvHD

Answer 19

Cytokine storm

Question 20

Risk of twins to have GvHD

Answer 20

No risk

Question 21

Treatment of GvhD

Answer 21

Corticosteroids, ciclospoin A, tacrolimus, mycophenolate mofetil

Question 22

Goal of autologous SCT

Answer 22

Kill ALL leukaemia with radio/chemotherpay

Question 23

Goal of allogenic SCT

Answer 23

Accepted that you cannot kill all leukaemia with radio/chemo so rely on BM from donor

Question 24

Why can you not just deplete donor lymphocytes prior to transplantation?

Answer 24

Increased risk of relapse also risk of CMV infection