造血干细胞移植Hematopoietic Stem Cell Transplantation课件.ppt

Mendels Rules of Heredity * Clinical Presentation could be Congestive, Edema, Bleeding, Diarrhea, bloody stool * Potral * * Autologous Stem Cell Transplants Allogeneic Stem Cell Transplants NEXT Laminar air flow Ward Step one of HSCT Screening Donor Induction Therapy for Leukemia Patient HLA typing for patient HLA-A, B, DR Screening for matched donor, Family or MUD Preparative Examination of Donor HLA typing of HLA-A, B, DR HLA-typing of Family Donor Step two of HSCT Mobilizing of HSC Activating and mobilizing stem cell Drugs: G-CSF, GM-CSF, CTX, etc Collecting HSC BM PBSC Mobilizing and Collecting of PBSC Collecting of BM stem cell STEP Three of HSCT Condition Regimen of Patient Principles of Conditioning Conditioning Regimens NST: Tumor eradication TRM Vs Engraft GVL Immuno Vs Bone-marrow suppression Principles of Conditioning Creation of space: Still Controversial concept Immunosuppression prevent Host-versus-Host reaction Disease Eradication Bone-Marrow suppression Get rid of tumor load Conditioning Regimens BuCy TBI/Cy FBC, etc BU: Busufan myeloablation Cy: cyclophosphamide Immunoablation TBI/Cy: Total Body Irradiation Immunoablation Vs Myeloablation Myeloablation ? Relapse TRM Immunoablation? Relapse TRM NST Immunoablation outweigh Myeloablation TRM DLI GVL Relapse Schematic Diagram of NST STEP FOUR OF HSCT Reinfusion of HSC STEP 5 Reconstitution Hematopoietic Reconstitution 2-3 weeks Immunology Reconstitution: GVL/GVT Less than 1 ys for B-cell Imunology M ore than 1-3 ys for T-cell Immunology Part 4Complications of HSCT Early Complications: HC, VOD, aGVHD Late complications: PTLD, cGVHD Infection Mechanism of GVHD Role of mHAGsin GVHD Complications Intestinal GVHD  Complications Skin GVHD GVH