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Questions and Answers
What does HSCT stand for?
Hematopoietic stem cell transplant
Where can replacement cells for a BMT or HSCT come from?
What are the two key properties of stem cells?
Long term cell renewal and cell differentiation
Cord blood is rich in hematopoietic stem cells (HSCs) that can differentiate into Red Blood Cells (RBCs), White Blood Cells (WBCs), and ______.
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Match the type of stem cell transplant with its description:
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What is the main cause of mortality associated with Acute GVHD?
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True or False: Graft-versus-host disease (GVHD) occurs when the donor's T cells view the patient's healthy cells as foreign and attack them.
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What are some common medications given to prevent GVHD?
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Nausea, vomiting, abdominal cramps, loss of appetite, and diarrhea are signs of involvement of the ______ tract in GVHD.
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Match the GVHD sign/symptom with the correct description:
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Study Notes
HEMATOPOIETIC STEM CELL TRANSPLANT
Course Learning Outcomes
- Discuss the causes, clinical features, laboratory investigation, and management of disorders related to anemia, white blood cell disorders, hemoglobin disorders, and bleeding & coagulation disorders.
- Analyze and solve cases with hematological findings to identify the possible condition or disease.
- Report hematological findings in written form to present case-related diseases.
Topic Outlines
- Definition of BM/HSCT
- Origin and differentiation of HSC
- Sources of HSC for transplantation
- Types of stem cell transplant
- Process of HSCT
- Complications associated with SCT
BM / Stem Cell Transplant
- Bone marrow transplant (BMT) is also known as stem cell transplant or hematopoietic stem cell transplant (HSCT).
- HSCT replaces bone marrow that has been destroyed by drugs, radiation, or disease with healthy cells.
- The replacement cells can come from the patient's own body (autologous) or from a donor (allogeneic).
Origin of HSC
- Stem cells are a class of unspecialized cells that can differentiate into specialized cells.
- Stem cells have two key properties: long-term cell renewal and cell differentiation.
- They can mature into cells for different parts of the body.
Sources of HSC for Transplant
- Bone marrow
- Peripheral blood
- Umbilical cord blood
Peripheral Blood SCT
- Stem cell mobilization involves using drugs to mobilize stem cells into the peripheral blood.
- Granulocyte colony stimulating factor (G-CSF) and Plerixafor (Mozobil) are commonly used drugs.
- These drugs are administered subcutaneously, right under the skin.
Umbilical Cord Blood (CB)
- Cord blood is collected from the umbilical cord and placenta after a baby is born.
- Cord blood is rich in hematopoietic stem cells (HSCs) that can differentiate into RBCs, WBCs, and platelets.
- Cord tissue also contains mesenchymal stem cells (MSCs) that can differentiate into a variety of cells.
Cord Blood Banking
- Blood stem cells are collected from the umbilical cord and can be processed and banked for public or private use.
- In Malaysia, the National Blood Bank and private companies such as CryoCord Sdn. Bhd. and StemLife Bhd. are involved in cord blood banking.
Types of HSC for Transplant
- Autologous transplantation (stem cells are harvested from the patient's own body)
- Allogenic transplantation (stem cells are harvested from a different person/donor)
Process of HSCT
- Collection of stem cells
- Processing
- Cryopreservation
- Conditioning and treatment
- Reinfusion into the patient
Allogenic Stem Cell Transplant and HLA Matching
- Human Leukocyte Antigen (HLA) matching is needed for allogenic transplant to find the best suitable donor.
- HLA proteins are clustered in the major histocompatibility complex (MHC) on the short arm of chromosome 6.
- Matching for the HLA-A, -B, -C, -DRB1, and -DQB1 loci is referred to as a 10/10 match.
Complications Associated with HSC Transplantation
- Graft-versus-host disease (GVHD)
- Hepatic sinusoidal obstruction syndrome
- Acute GVHD occurs before day 100 of post-transplant and remains the major cause of mortality.
- Chronic GVHD occurs after day 100 and can be life-threatening.
Graft-Versus-Host Disease (GVHD)
- GVHD is a potentially serious complication of allogeneic stem cell transplantation.
- GVHD occurs when the donor's T cells view the patient's healthy cells as foreign and attack and damage them.
- GVHD can be treated with steroids or other immunosuppressive agents.
- Symptoms of GVHD include nausea, vomiting, abdominal cramps, loss of appetite, diarrhea, jaundice, and skin rashes.
Choosing the Best Cell Source for Transplant
- The best cell source depends on the patient's disease, overall health, how quickly the transplant is needed, and the number of blood-forming cells required.
- Doctors will choose the best cell source based on these factors.
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Description
This course focuses on advanced hematology, specifically hematopoietic stem cell transplant. Students will learn about the role of stem cells in hematopoiesis and the process of transplantation.
