3. Pathology
Treat Leukemia by chemotherapy
Regeneration of normal marrow
Chemotherapy alone cannot eliminate
all malignant cells
Stem cell transplants.
4. Transplant
Patient's bone marrow stem cells are
replaced with healthy cells
Existing bone marrow and abnormal
leukocytes killed
Chemotherapy and radiation
Next bone marrow containing healthy
stem cells re-infused
7. Procedure
Most blood stem cells reside in the
bone marrow and a small number are
present in the bloodstream
Multipotent peripheral blood stem
cells
Can be obtained from drawn blood
PBSCs are easier to collect than bone
marrow stem cells
9. Umbilical Cord Blood Stem Cell
Transplant
Umbilical cords have traditionally
been discarded as a by-product of the
birth process.
Pluripotent-stem-cell-rich blood found
in the umbilical cord rich in marrow
stem cells and PBSC’s.
10. Umbilical Cord Tx
Umbilical cord transplants are less
prone to rejection.
Cells have not yet developed the
features that can be recognized and
attacked by the recipient's immune
system.
Umbilical cord blood lacks well-
developed immune cells, there is
smaller incidence of graft versus host
disease.
12. THE FUNCTION OF BMT UNIT
Handling services & Intensive care
for:
Mobilization / stem cell collection &
infusion.
Chemotherapy for pre - transplant
Pre & post care for Transplant
patients.
16. Recovering from the transplant
Recovery of normal levels cells is called
engraftment
Day 8 - 12
Neutrophil engraftment important (GCSF)
may be given to accelerate the process
Platelets are the next to return with red
cells last.
Commonly patients require transfusion of
red cells and platelets following a
transplant.
Discharge upon neutrophil & platelet
engraftment
18. Graft Verses Host Disease
(GVHD)
GVHD sometimes occurs with allogeneic
transplantation.
Lymphocytes from the donor graft attack the cells of
the host
GVHD can usually be treated with steroids or other
immunosuppressive agents.
Acute GVHD occurs before day 100 post-transplant
Chronic GVHD occurs beyond day 100
Recent advances have reduced the incidence and
severity of this post-transplant complication, but
GVHD, directly or indirectly, still accounts for
approximately 15% of deaths in stem cell transplant
patients
Chronic GVHD can develop months or even years
post-transplant