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Title: Haematopoietic Stem cell transplant
Description: Useful short questions and answers I wrote based on UCL biomedical sciences third year Haematopoietic Stem cell transplant lecture. To get a 2.1/1st you really should be able to answer all of these.
Description: Useful short questions and answers I wrote based on UCL biomedical sciences third year Haematopoietic Stem cell transplant lecture. To get a 2.1/1st you really should be able to answer all of these.
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Haematopoietic Stem cell transplant
Questions
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How many people have HSCTs per year?
Name three cancer diagnoses
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What is GVHD
Are HSCs rare?
What three kinds of HSCTs can there be?
Which is the most standard? Who did it first and when?
What is the main issue with allogenic HSCT? Why?
Future goal?
What is GVTE?
What is GVTE trying to fix?
What are the three ways to harvest HSCs?
Discuss BM harvesting
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What is being trailed to prevent chronic GVHD?
When was the first Umbilical cord blood transplant tried?
Where has UCB been really useful?
What are the advantages?
Major limitation?
How is this limitation being reduced?
What is the major issue with immunosuppressive drugs? Name two
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What is a problem with gene therapy?
Major advantages of iPSCs?
Answers
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Autologous, syngeneic, allogenic
Allogenic… Ed Thomas… 1969
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Due to the high polymorphic nature of the Human
leukocyte Antigen (HLA) loci on Chromosome 6
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MHC class I are encoded by HLA-A,-B,C and MHC class II and encoded by HLA –DP, -DQ, -DR
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In a transplant ideally have a 10/10 match
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Graft Vs tumour effect is when donor lymphocytes still present in the graft recognise and
attack tumour antigens
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BM, PBSC, UCB
Standard for over 40 years
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2-3 punctures are made into the BM cavity of the hip bone
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2 L)
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HSCs have
chemokine receptors, e
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CXCR4, for stromal cells SDF-1
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Plerixafor
blocks the interaction with SDF-1 while GCSF blocks many interaction between the HSCs and
the stromal cells
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The donors blood is then drawn
out using an apheresis machine
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The engraftment of PBSCs used in transplant is 11-14 days compared to BM 21 days
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Less graft rejection and harvesting large numbers is quick, easy and cheap
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Anti-lymphocyte globulin (ALG)
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1989
In ethnic minorities who have less of a chance of finding HLA match, and UCB transplants
can tolerate a bigger HLA mismatch
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Cord blood banks are
growing rapidly as no risk to mother or baby and cord/placenta are normally just medical
waste
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Blood from one umbilical cord does not contain many SCs which can lead to graft failure in
adults (okay in children)
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By using blood from two umbilical cords
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g
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This molecules increased Wnt signalling in HSCs and enhances
self-renewal properties, which is imp for long term maintenance
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High toxicity
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CAMPATH-1H (alemtuzumab) – part of immunosuppressive therapy
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Used to remove T cells from the graft during
infusion, by targeting them for destruction via Ab-dependent cell-mediated cytotoxicity
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The signalling domain of the T cells is bound with the singlechain variable fragment of tumour specific antibodies
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Viral vectors expressing a gene
which is normally not present within cells, HSV-TK, is genetically engineered into donor T
cells
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The drug ganciclovir is given to
activate the HSV-TK, which causes DNA synthesis inhibition and apoptosis of the cell
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HSC gene therapy
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Also iPSCs
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These could then be transplanted back into the patient
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Can switch on unwanted oncogenes
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Would eliminate the need for immunosuppressive drugs and allogenic transplants…
therefore a transplant available for everyone!!
Title: Haematopoietic Stem cell transplant
Description: Useful short questions and answers I wrote based on UCL biomedical sciences third year Haematopoietic Stem cell transplant lecture. To get a 2.1/1st you really should be able to answer all of these.
Description: Useful short questions and answers I wrote based on UCL biomedical sciences third year Haematopoietic Stem cell transplant lecture. To get a 2.1/1st you really should be able to answer all of these.