Week 12

Question 1

List the 3 main sources of haematopoietic stem cells

Answer 1

1. Peripheral blood
2. Bone marrow
3. Umbilical cord blood

Question 2

Name the 3 TYPES of haematopoietic stem cells

Answer 2

AUTOLOGOUS
ALLOGENEIC
SYNGENEIC

Question 3

AUTOLOGOUS

Answer 3

→ Self

Question 4

ALLOGENEIC

Answer 4

→Genetically different donor

E.g. Sibling, Unrelated donor

Question 5

SYNGENEIC

Answer 5

→ Identical twin donor

Question 6

Peripheral blood stem cell (PBSC) collection in normally collected by _________.

Answer 6

apheresis

Question 7

How do you increase Peripheral blood stem cell yield?

Answer 7

• Mobilise Peripheral blood stem cell with growth factors

Question 8

What is an example of growth factors to increase Peripheral blood stem cell yield?

Answer 8

granulocyte colony stimulating factor (G-CSF)

Note: G-CSF increases number by 10 -100 times

Question 9

List one example of an inhibitor of stem cell adhesion receptor

Answer 9

Plerixafor

Question 10

How do you measure the yield of harvesting?

Answer 10

Yeild is assessed by CD34+ cell count

Note: it’s generally > 2 – 4 x 106/kg CD34+ cells needed

Question 11

Name that cell:
is a transmembrane phosphoglycoprotein,
• first identified on hematopoietic stem and
progenitor cells

Answer 11

CD34+

Question 12

What are the advantages of peripheral blood stem cell collection?

Answer 12

✓ Large volumes can be collected (higher than BM which mean shorter engraftment time)
✓ No anaesthesia required

Question 13

What are the Limitations of peripheral blood stem cell collection?

Answer 13

▪ Requires apheresis equipment

▪ Greater incidence of GvHD for allogeneic transplant

Question 14

Cord blood is rich in which cells?

Answer 14

Rich in potent haematopoietic progenitor cells

Question 15

In cord blood stem cell transplant is the risk of GvHD is much lower or much higher?

Answer 15

Lower

o Greater number of HLA mismatches can be tolerated

Question 16

Does cord blood have fewer or more haematopoietic progenitor cells than BM or PB harvest?

Answer 16

Fewer

Question 17

Is cord blood more useful for children’s transplant?

Answer 17

Yes

Question 18

Is the risk of risk of non-engraftment is higher or lower in cord blood transplants?

Answer 18

Higher

Question 19

Hematopoietic stem cell antigen (used as a marker)

Answer 19

CD34+

Question 20

In Autologous BMT (Mobilisation & Harvesting) What cells are collected or from where?

Answer 20

Patient’s own cells being collected

Question 21

In Allogeneic BMT (Mobilisation & Harvesting) What cells are collected or from where?

Answer 21

Donor provides peripheral blood stem cells.

Question 22

What are two types of Conditioning for Allogeneic transplants? Comment on age groups

Answer 22

Marrow ablative (MA) - mostly younger
Reduced intensity conditioning (RIC) - can be used on older individuals

Question 23

What is the key advantage and key risk for autologous stem cell transplants?

Answer 23

Advantage - No Graft vs Host Disease

Risk - Return of malignancy

Question 24

What is the key advantage and key risk for allogeneic stem cell transplants?

Answer 24

Advantage - Graft vs malignancy effect

Risk - Graft vs Host Disease

Question 25

Major determinants of complexity for stem cell transplant?

Answer 25

1. Donor status (Related or unrelated) 2. Source of stem cells (BM, PB, or Cord) 3. Acuity of patient’s underlying disease

Question 26

What are some early Complications of stem cell transplantation?

Answer 26

Infection Haemorrhage Acute pattern GvHD Graft failure

Question 27

What are some late Complications of stem cell transplantation?

Answer 27

``` Infection Chronic pattern GvHD Autoimmune disorders Cataract Infertility ```

Question 28

What are some risk factors that can lead to GvHD?

Answer 28

• Patient age • Disease stage • Sex mismatch with donor (Donor T-cells recognise antigens associated with Y chromosome)

Question 29

Are infections more common in allogeneic or autologous?

Answer 29

Allogeneic

Question 30

What is the most common infection for early phase and late phase allogeneic transplants?

Answer 30

Early - bacteria | Late - viral

Question 31

In over 16yr olds is transfusion related mortality more common in autologous patients or identical sibling

Answer 31

identical sibling

Question 32

Fpr acute leukaemias when is the transplant usually performed?

Answer 32

1st or 2nd remission

Question 33

What is only potential curative treatment for MDS?

Answer 33

Allogeneic transplant

Question 34

What is the standard of care for lymphoma in many instances?

Answer 34

Autologous transplant

Question 35

HLA gene found on ______ arm of chromosome __.

Answer 35

short, 6

Question 36

What is the HLA role?

Answer 36

Present peptides to T cells so that they can recognise & eliminate foreign or non-self particles

Question 37

What does HLA stand for?

Answer 37

Human Leukocyte Antigen

Question 38

Histocompatibility testing for transplantation: Class I antigens: Class II antigen:

Answer 38

Class I antigens: HLA-A, B, C | Class II antigen: HLA-DR and DQ

Question 39

What administration regulates human tissue transplantation

Answer 39

Therapeutic Goods Administration (TGA)