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    Transplants From Unrelated Donors

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    KeepItSecret
    This document discusses unrelated cord blood transplantation and the factors that affect outcomes. It notes that HLA mismatch level between donor and recipient impacts results, and that mismatches can be bidirectional. The document also addresses the two main pathways of T-cell regeneration, causes of secondary cytopenia after transplantation, and the current directions of using single transcription factors or expanding adult stem cells for transplantation purposes.

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    Transplants From Unrelated Donors

    Uploaded by

    KeepItSecret
    11 views8 pages
    This document discusses unrelated cord blood transplantation and the factors that affect outcomes. It notes that HLA mismatch level between donor and recipient impacts results, and that mismatches can be bidirectional. The document also addresses the two main pathways of T-cell regeneration, causes of secondary cytopenia after transplantation, and the current directions of using single transcription factors or expanding adult stem cells for transplantation purposes.

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    MADAYA 32.pptx

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    This document discusses unrelated cord blood transplantation and the factors that affect outcomes. It notes that HLA mismatch level between donor and recipient impacts results, and that mismatches can be bidirectional. The document also addresses the two main pathways of T-cell regeneration, causes of secondary cytopenia after transplantation, and the current directions of using single transcription factors or expanding adult stem cells for transplantation purposes.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    11 views8 pages

    Transplants From Unrelated Donors

    Uploaded by

    KeepItSecret
    This document discusses unrelated cord blood transplantation and the factors that affect outcomes. It notes that HLA mismatch level between donor and recipient impacts results, and that mismatches can be bidirectional. The document also addresses the two main pathways of T-cell regeneration, causes of secondary cytopenia after transplantation, and the current directions of using single transcription factors or expanding adult stem cells for transplantation purposes.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 8

    Transplants from Unrelated Donors

    • Cord blood from unrelated donors has become an


    important source of hematopoietic stem cells (HSCs).
    • The donor-recipient HLA mismatch level affects the
    outcome of unrelated cord blood transplantation. 
    • Possible permissive mismatches involve the relationship
    between direction HLA mismatch vector or direction and
    transplantation outcomes.
    • In most cord blood transplants, a mismatched HLA
    antigen is present in recipient and donor. This type of
    mismatch is bidirectional between the graft and host.
    Two main pathways of T-cell
    regeneration
    • Thymopoiesis and peripheral blood expansion of mature
    T cells. 
    • Thymopoiesis provides a new pool of naïve T cells that
    is essential for sustained long-term immunity.
    • Secondary cytopenia is a common complication of stem
    cell transplantation. 
    • Causes of secondary cytopenia include viral infection,
    septicemia, GVHD, and myelotoxicdrugs.
    Current Directions
    • Consists of direct reprogramming of skin cells to
    a multipotent progenitor stage by the introduction of a
    single transcription factor, Oct4.
    • Another potential game-changing advancement would
    be the ability to reprogram human adult stem cells to
    an expandable condition without reducing the long-
    term self renewal properties and their safety. 
    • The general goal of this field is transplanting donor
    stem cells to replace or repair defective cells in a
    patient.
    There are two critical concerns in
    the transplantation of umbilical cord
    blood:
    • 1. Initial time to engraftment 
    2. Restoration of immune function
    • The initial engraftment of cells that develop into the
    myeloid cell line (red blood cells, platelets, and
    granulocyte/monocyte) is 1 month. 
    • Development of T- and B-lymphocytes commonly takes
    6 months or more after transplantation.
    Two factors have been found to be
    of extreme importance:
    • 1.The total dose of progenitor (CD34+) cells in a cord
    blood unit has been associated with patient survival
    • 2.The total dose of clonogenic progenitors with the graft
    correlates with engraftment of the transplant.
    • To transplant stem cells into a fetus early in gestation.
    The benefit is that in utero transplantation would occur
    when the immune system of the fetus is immature,
    which would provide the theoretical opportunity to
    induce fetal tolerance of foreign cells. 
    • This would avoid rejection and the need for
    immunosuppressive therapy.

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