Bone Marrow Transplantation.ppt

/home/eyevstratov Bone Marrow Transplantation Just Names E.Donall Thomas George Santos vanBekkum George Mathe Indications Acute and chronic leukemias Aplastic anemia Congenital immunodeficiency diseases Lymphomas Metabolic disease of childhood Myelodisplasia Thalassemia Donor Limitations 25 – 30% of patients have an HLA-identical sibling. Marrow procured from unrelated living donor Marrow procured from related HLA-identical or HLA non –identical living donor Autologous transolantation(marroe procured during remession) Recipient preparation Cyclophosphamide 60 mg/kg/day During two days and Toal body irradiation Busulfan 4mg/kg/day for fur days and Cyclophosphamide without irradiation Etoposide ,Cyarabine as a maximizer antitumor properties,myeloblation,immunosuppression Transplantation Procedure Anesthesic Management Intravenouse anesthesia sould be procured. Intravenouse Thiopental,Fentanyl,Vecuronium can be used in common doses Maintanance can be provide with Propofol and Isoflurane. Nota Bene Complications Rejection by hte host of the marow graft Acute graft-vs,-host disease (GVHD) Infections Chronic GVHD Prolonged immunodeficiency Disease recurrence * * The transfer of living cells, tissues, or organs from a donor to a recipient, with the intention of maintaining the functional integrity of the transplanted material in the recipient /home/eyevstratov Nitrouse Oxide should be avoided as an inactivator of Vit B12 wich is an essential coenzyme for methionine synthetase.This enzyme facilitate the conversion of homocystine and methyltetehydrofolate to methionine are essential for deoxyribonucleic acid (DNA) synthesis. Eugene Yevstratov MD Zacarias C.Vargas MD Bone morrow transplantation started in laboratory work with animals.? None of these procedures ever starts with humans; it always starts with ideas that you work on in the lab. It started in the earliest days with E. Donall Thomas and George Santos in this country and van Bekkum and George Mathe in Europe.?