Hemopoietic Precursors in Human Bone Marrow Transplantation
|
|
- Gwendolyn Paul
- 5 years ago
- Views:
Transcription
1 International Journal of Cell Cloning 4: Suppl 1 (1986) Hemopoietic Precursors in Human Bone Marrow Transplantation H.A. Messner Ontario Cancer Institute, University of Toronto, Toronto, Ontario, Canada Key Words. Clonogenic precursors * CFU-gem * BFU-e CFU-m * CFU-c - Hemopoietic growth factors * Cell culture Cell cycle status Introduction The majority of bone marrow transplant recipients with long-term disease-free survival are usually able to produce peripheral blood cells in normal frequency. In spite of these normal values, transplant recipients appear to be at higher risk to suffer from severe life-threatening infections and display difficulties coping with increasing demands. This problem may relate to an incomplete reserve of early hernopoietic precursors within the engrafted marrow. We have, therefore, asked two questions: 1. Does the frequency of clonogenic precursors and their proliferative status return to normal values? 2. Does the time up to engraftrnent and the duration of survival correlate with the frequency of clonogenic cells in the transplant inoculum or can they be predicted by colony formation of the host prior to transplantation? Assay for Clonogenic Precursors The assays for clonogenic hemopoietic precursors are well established. Briefly, Percoll-separated mononuclear bone marrow cells of density less than g/ml are plated in methylcellulose supplemented with human plasma, Iscove s minimum essential medium, 2-mercaptoethanol and PHA-LCM as a source of hemopoietic Correspondence: Dr. Hans A. Messner, Ontario Cancer Institute, 500 Sherbourne Street, Toronto, Ontario, Canada M4X 1K /86/$2.00/0 oalphamed Press, Inc.
2 Messner 12 growth-promoting factors [l, 21. Plates are scored after 14 days of incubation at 37T in humidified air, supplemented with 5% COz. These growth conditions support the development of multi- and single-lineage colonies, thus providing a measurement for pluripotent and committed hemopoietic precursors. In addition, the use of human plasma in the system has given the opportunity to assay plasma samples in transplant recipients for the presence of hemopoietic growth factors. These may be anticipated during early bone marrow regeneration. Hemopoietic Precursors in Bone Marrow Transplantation Recipients The culture analysis was performed on 103 bone marrow recipients and their respective donors. Almost all recipients demonstrated some colony growth one month after transplantation [3]. The mean values of clonogenic cells for the whole group may increase slightly over the subsequent two or three months and then remain constant up to the maximal follow-up of five years at 30%-40% of normal. These values are independent of the age, diagnosis and status of disease at transplantation. In spite of the decreased frequency of clonogenic precursors, normal peripheral blood parameters are maintained. This may be feasible by involving a greater than normal proportion of clonogenic precursors into ongoing proliferation. This hypothesis was tested by determining the number of clonogenic precursors in S-phase using the H3TdR suicide technique [4]. Incubation with H TdR of normal bone marrow samples prior to plating resulted in a reduction of the plating efficiency that ranged from 5% -35% of pluripotent precursors. In contrast, bone marrow transplant recipients whose counts had returned to normal appeared to be more sensitive to preincubation with H TdR. This observation is consistent with the view that hemopoiesis in bone marrow transplant recipients is maintained by a smaller number of precursors. All of these appear to cycle actively, thus indicating a decreased reserve of clonogenic precursors. Contribution of Cells in the Winsplant Inoculum to the Clinical Outcome Each one of the transplant inocula was collected with the target to provide 3 x 108 nucleated cells per kg of the recipient. An aliquot was used to enumerate the frequency of clonogenic precursors in culture. Considerable patient-to-patient heterogeneity was observed. The total number of nucleated cells varied as much as threefold covering a spread from 1.2 to 4.2 x 1Olo with a median of 2.4 x lolo cells. The frequency of clonogenic cells showed even greater variation of up to eightfold differences. The frequency of each of these subpopulations was exam-
3 Hemopoietic Precursors in BMT 13 ined to determine their influence on the clinical outcome measured by the time that had elapsed to achieve engraftment and by the length of survival. For this study, time to engraftment was defined as the interval required to sustain more than 50,000 platelets, 50,000 reticulocytes and 1,500 neutrophil granulocytes per mm3. Using a uni- and multivariate analysis, clonogenic precursors in the transplant inoculum were not correlated with either measurement of clinical outcome. In contrast, the total number of nucleated cells in the transplant inoculum contributed significantly to survival. Patients that had received a higher cell load had a higher probability of survival independent of other risk factors. This result was somewhat surprising. A number of hypotheses may be advanced to explain the findings. For instance, the clonogenic cells measured by the employed assays are not important for engraftment. This notion may be supported by observations in autologous bone marrow transplantation, where the transplanted marrow was pretreated with 4-hydroperoxycyclophosphamide. Functional grafts were obtained even after clonogenic cells were reduced to 10% or less [5]. It is conceivable that stable engraftment is the result of a more primitive stem cell represented in even lower frequency. A higher number of nucleated cells may then have a higher probability to contain them in sufficient frequency. Alternatively, engraftment may not only depend upon clonogenic precursors but also require the simultaneous transfusion of auxiliary cells, such as T lymphocytes. This possibility is supported by experiences transplanting T cell depleted bone marrow. Difficulties with engraftment are encountered in 1O%-l5% of these transplants. In a preliminary study, attempts were made to increase the frequency of nucleated cells in the transplant inoculum above the usual value of 3 XlOVkg recipient. Four of the five patients evaluated demonstrated clonogenic precursors as early as days 14 and 28 in a frequency that approximated normal values. The number of studied patients is too small and the time of follow-up is too short to determine whether the increased number of transplanted cells is not only reflected by an increased frequency in clonogenic precursors in the recipient but also by improved survival. Influence of Clinical Outcome by Clonogenic Precursors in the Recipient Prior to Transplantation Bone marrow samples from each transplant recipient were assessed prior to transplantation for the frequency of pluripotent and committed hemopoietic precursors. The influence of each of these values on clinical outcome was assessed using time to engraftment and survival as measurements.
4 Messner 14 The study revealed that only clonogenic precursors committed to megakayocytopoiesis (CFU-m) significantly influenced the time to engraftment. Recipients with high pre-transplant values of CFU-m engrafted faster than recipients with low CFU-m values. None of the pretransplant clonogenic precursors in the recipient had any influence on survival. The role that CFU-m in the recipient may play resulting in the observed correlation is open for speculation. It is unlikely that they reflect a more primitive stem cell population, although data are available in murine hemopoiesis that CFU-m and day 14 CFU-s [6] are recognized by the identical monoclonal antibody Qa-m2. Alternatively, the growth of CFU-m may reflect events in vivo that support the growth of clonogenic precursors. It may therefore indirectly measure the activity of auxilliary cell populations or the release of stimulatory molecules required for CFU-m growth. Based on this speculation, attempts were made to measure a growth supporting influence directly. CFU-m represent a suitable model since megakaryocyte colony formation is dependent upon the presence of a source of human plasma in the cultures [l, 21. Colony formation with normal human plasma, however, is only observed if a source of Meg-CSA is added. This can be provided by addition of PHA-EM. In contrast, plasma from patients with perturbed megakaryocytopoiesis, as for instance observed in aplastic anemia, may contain substances that not only support colony growth, but also replace the requirement for exogenous Meg-CSA. The question was asked whether or not similar activities can be observed in transplant recipients and whether these are predictive of engraftment [2]. Plasma samples were obtained before transplantation and serially thereafter. Routinely stimulatory activities can be identified as early as during administration of the ablative chemotherapy. In general, two main activity patterns were identified. Some patients increased the stimulatory activities to peak values between day 10 and day 20. Subsequently, these peak values decreased and disappeared approximately 30 days after transplantation. In a second subset of individuals, activities are sustained in plasma well beyond day 30. Attempts to correlate the activity within the plasma of transplant recipients yielded the following information. Recipients whose plasma returned to normal values within 30 days after transplantation tended to recover platelets faster than patients with sustained activity. Thus, delayed engraftment appears to be more related to cellular problems rather than the absence of stimulators. These observations provide some insight into the complexity of events that are associated with engraftment. In addition, one has to realize, however, that the interactions with drugs such as steroids and cyclosporine A, antiviral agents, the development of infections and GVHD may further complicate the issue. More!
5 Hemopoietic Precursors in BMT 15 detailed studies are required to delineate the influence of each of these nonhemopoietic parameters. References Messner HA, Jamal N, Izaguim C. The growth of large megakaryocyte colonies from human bone marrow. J Cell Physiol 1982;1: Solberg LA, Jamal N, Messner HA. Characterization of human megakaryocytic colony formation in human plasma. J Cell Physiol 1985;124: Messner HA, Curtis JE, Minden MD, et al. Clonogenic hemopoietic precursors in bone marrow transplantation. Submitted. Minden MD, Till JE, McCulloch EA. Proliferation state of blast cell progenitors in acute myeloblastic leukemia (AML). Blood 1978;52: Rowley SD, Stuart RK. 4-HydroperoxycycIophosphamide (4-HC) effects on human pluripotent stem cells (CFU-gemm) in vitro. J Exp Hematol 1983;Suppl 1: Abstract No. 11. Harris R4, Hogarth PM, Wadeson LJ, Collins P, McKenzie IFC, Penington DG. An antigenic difference between cells forming early and late haematopoietic spleen colonies (CFU-s). Nature 1984;307: Discussion Ho: I would just like to point out that the quality of cells that you are obtaining in the latter part of the operation is probably not the same as that you obtained in the first 15 minutes of aspiration. So, we re dealing with different populations of cells here. This complicates the type of analysis. I think it has been universally observed that there is no increase in graft-versus-host disease regardless of the total number of nucleated cells that one gives to the patient. That observation again complicates a comparison with T cell depleted marrow, I have one other comment in regards to interpreting these data on hemopoietic precursors. We have been puzzled by the same point that you have shown in regards to the clonogenicity of the marrow after transplantation. Just for the fun of it, we have discussed the suggestion among ourselves that perhaps stem cells are not as immortal as we used to think and that there may be a limit to the number of generations that these cells are able to go through. Probably these are lasting longer than the lifetime of an individual. However, when one uses these cells to transplant into a recipient, a number of generations have to be used in order to repopulate the bone marrow compartment. Therefore, these cells may then show this limit of clonogenicity after transplantation. Messner: You also find in the literature the experience that a reduction of the clonogenic components with agents like 4-hydroperoxycyclophosphamide has not im-
6 Messner 16 paired the ability of these marrow specimens to repopulate hemopoiesis. So that s precisely what I wanted to point out: that I think the available assays may therefore not measure the relevant population or we may not have the right concept of how these cells contribute to hemopoiesis. Sullivan: I presume these were patients with leukemia. Why was survival improved in those patients receiving greater than 2.4 x 10 0 nucleated cells in total? Was it protection from relapse, or lowered non-relapse death rates? Messner: The whole group of individuals were not selected for a specific disease. This group included some patients with aplastic anemia, and some patients with acute myeloid and lymphoid and chronic myeloid leukemia. The main problem that we encountered was related to infections and graft-versus-host disease. Our relapse rate in the whole group was relatively low, that is, 10% for patients transplanted in first remission of acute leukemia and patients with CML in chronic phase. Sullivan: We ve looked at this several times and several other centers have not been able to find such a correlate in leukemia patients receiving TBI and cell dose. Is it possible that the larger cell dose on that curve was a reflection of younger age recipients vis-a-vis less graft-versus-host disease and infections? Messner: That is a possibility. The data shown only considered patients below the age of 30. However, if the very same analysis is performed for older patients, the difference between patients receiving a low and high cell load is sustained. Sullivan: Yes, especially if you had to break it down under age 10, those children tend to get very large cell doses and that might influence the results. Messner: Our youngest patient in that group was 14, the majority between 18 and 30. Prchal: The speculation is possible that these clonogenic cells are restricted to a certain number of generations. But it is equally possible that two years posttransplantation, it was not possible to restore a normal stem cell pool of its usual size. Do you, or does anybody else, have any data at a later time than five years? Messner: We have reanalyzed the data after three, four and five years. About 15 patients have reached four years and about five have reached five years. No increment in clonogenic cells was observed in that small patient population.
7 Hemopoietic Precursors in BMT 17 Gelfand: This is a very impressive collection of data, but I wonder if in a way you don t set yourself an impossible task in that there are so many variables that go on in the post-transplant period, such as the influence of drugs, graft-versushost disease and so on. One of the impressive things that we have done with Me1 Freedman on colony formation is to study the impact of the lymphopoietic system on hematopoiesis by adding simple things such as exogenous IL2 to cultures. Since many of the post-bone marrow transplant recipients have problems with IL-2 production, including the number of T cells in IL2 production in their own culture system from the bone marrow with PHA, it seems to me that unless one is able to control these variables, it is almost impossible to get a correlation. Messner: The information that we can derive from these data is a quantitative and qualitative assessment of precursors at various timepoints. One can demonstrate a reduced frequency and one can show differences in their functional status. The chosen culture conditions provide IL-2-like substances in the form of PHA-LCM. Keating: Given the notion that perhaps the semisolid clonal assays are unable to assay for stem cells that cause engraftment, have you considered the use of longterm marrow cultures in assessing the effect of transplantation on marrow? Messner: Lmg-term bone marrow cultures may provide the opportunity to examine additional precursor populations that may be more relevant for transplantation. Keating: I was very intrigued by your recipient data with regard to time to engraftment with CFU-Meg. As you know, there is some evidence now from us and from other groups, that suggests that platelet-derived growth factor is a mitogen for the marrow microenvironment. The other piece of information is from Russell Ross s lab in Seattle that there is some evidence that megakaryocytic precursors synthesize PDGF in appreciable quantities. Given that data, do you think that the mechanism for the improved engraftment with increase in CFU-Meg in the recipient might be related to the increase in PDGF which might stimulate the newly generating microenvironment? Could you comment on that? Messner: This is quite possible. I m only aware of data where PDGF was used directly on bone marrow samples in the short-term assay. PDGF itself did apparently not directly influence the growth of clonogenic cells.
8 Messner 18 Keating: Both CFU-gem and also BFU-e have been shown, in marrow at least, to be augmented by PDGF. This probably functions through an accessory cell population. Saunders: I wonder how specific the phenomenon of low stem cell colonies posttransplant is. A number of years ago, I had the opportunity to do some follow-up marrows on patients with aplastic anemia who were not transplanted. There were just a few of them. They were, for all intents and purposes, spontaneous cures of aplastic anemia. They had normal blood counts. They were anywhere from 5-10 years post-aplasia. And they had very few stem cells in their marrows. Messner: I can only refer back to a number of patients with acute myeloid leukemia, who were examined three and four years after completion of chemotherapy. These patients also demonstrated very low frequency of clonogenic cells. A cell cycle state analysis, on the same samples, demonstrated increased cell cycle activity. So I think an injured marrow can really be reflected in the frequency of precursors and in their cell cycle state. Miller: The critical question in these low stem cells is whether one is looking at a small mismatch between host and donor or whether one is looking at an injured environment. Has anyone done the appropriate mouse experiment, which would be to look at mice that have been radiated and reconstituted with syngeneic bone marrow and then followed over a long period of time? That s not quite the same as the decline experiment, which does show serial decline in stem cells. Has that experiment been done? Messner: I have not seen any data. Gleichmann: I have a similar question. Your data remind me of some of the older findings in mice that were called allogeneic inhibition or Fl hybrid resistance, that describe the poor engraftment and rather small donor cell inoculum of stem cells that can rarely be overcome by increasing the donor cells. I wonder whether this has anything to do with that. Therefore, it would be interesting to control this in identical twin donor-recipient pairs, because there you should not see it. And that could also answer the question raised before, whether there is a poor proliferative capacity or restricted proliferative capacity of the stem cells or not, whether this is allogeneic inhibition. Messner: I don t have sufficient transplants in twins to be able to comment.
Rapid Decline of Clonogenic Hemopoietic Progenitors in Semisolid Cultures of Bone Marrow Samples Derived from Patients with Chronic Myeloid Leukemia
Original Manuscript International Journal of Cell Cloning 7314-321 (1989) Rapid Decline of Clonogenic Hemopoietic Progenitors in Semisolid Cultures of Bone Marrow Samples Derived from Patients with Chronic
More informationManipulation of T Cells in the Thnsplant Inoculum
International Journal of Cell Cloning 4: 122-126 Suppl 1 (1986) Manipulation of T Cells in the Thnsplant Inoculum J. Kersey Bone Marrow Transplantation Program, University of Minnesota, Minneapolis, MN,
More informationHematopoietic Stem Cells, Stem Cell Processing, and Transplantation
Hematopoietic Stem Cells, Stem Cell Processing, and Joseph (Yossi) Schwartz, M irector, Hemotherapy and Stem Cell Processing Facility Bone Marrow Can Cure: Leukemia Lymphoma Multiple Myeloma Genetic iseases:
More informationCord Blood Stem Cell Banking and Transplantation
Cord Blood Stem Cell Banking and Transplantation JOHN W. ADAMSON New York Blood Center, New York, New York, USA Key Words. Cord blood Stem cells Cord blood banking Cord blood transplantation. Cord blood.stern
More informationMyeloproliferative Disorders - D Savage - 9 Jan 2002
Disease Usual phenotype acute leukemia precursor chronic leukemia low grade lymphoma myeloma differentiated Total WBC > 60 leukemoid reaction acute leukemia Blast Pro Myel Meta Band Seg Lymph 0 0 0 2
More informationFeasibility of hyperthermia as a purging modality in autologous bone marrow transplantation Wierenga, Pieter Klaas
University of Groningen Feasibility of hyperthermia as a purging modality in autologous bone marrow transplantation Wierenga, Pieter Klaas IMPORTANT NOTE: You are advised to consult the publisher's version
More informationNeutrophil Recovery: The. Posttransplant Recovery. Bus11_1.ppt
Neutrophil Recovery: The First Step in Posttransplant Recovery No conflicts of interest to disclose Bus11_1.ppt Blood is Made in the Bone Marrow Blood Stem Cell Pre-B White cells B Lymphocyte T Lymphocyte
More informationUnderstanding the role of ex vivo T cell depletion
Prevention of graftversus-host disease (GVHD) Understanding the role of ex vivo T cell depletion Information for patients undergoing allogeneic stem cell transplantation in AML and their families 2 This
More informationTrends in Hematopoietic Cell Transplantation. AAMAC Patient Education Day Oct 2014
Trends in Hematopoietic Cell Transplantation AAMAC Patient Education Day Oct 2014 Objectives Review the principles behind allogeneic stem cell transplantation Outline the process of transplant, some of
More informationStem cells: units of development and regeneration. Fernando D. Camargo Ph.D. Whitehead Fellow Whitehead Institute for Biomedical Research.
Stem cells: units of development and regeneration Fernando D. Camargo Ph.D. Whitehead Fellow Whitehead Institute for Biomedical Research Concepts 1. Embryonic vs. adult stem cells 2. Hematopoietic stem
More informationDifferentiation Ability of Peripheral Blood Cells from Patients with Acute Leukemia or Blast Crisis in Chronic Myelocytic Leukemia"
Differentiation Ability of Peripheral Blood Cells from Patients with Acute Leukemia or Blast Crisis in Chronic Myelocytic Leukemia" Hoelzer, D.,l, Harriss, E. B.l, Kurrle, E.l, Schmücker, H.l, Hellriegel,
More informationHematopoietic Stem Cells
Hematopoietic Stem Cells, Stem Cell Processing, and Joseph (Yossi) Schwartz, M irector, Hemotherapy and Stem Cell Processing Facility E-mail: js2745@columbia.edu Hematopoietic Stem Cells Sustain hematopoiesis
More informationOne Day BMT Course by Thai Society of Hematology. Management of Graft Failure and Relapsed Diseases
One Day BMT Course by Thai Society of Hematology Management of Graft Failure and Relapsed Diseases Piya Rujkijyanont, MD Division of Hematology-Oncology Department of Pediatrics Phramongkutklao Hospital
More informationAplastic anemia. Case report. Effect of antithymocyte globulin on erythroid colony formation
Case report Aplastic anemia Effect of antithymocyte globulin on erythroid colony formation Susan A. Rothmann Hamburger, Ph.D. Department of Laboratory Hematology and Blood Banking James H. Finke, Ph.D.
More informationCD34+ Cells: A Comparison of Stem and Progenitor Cells in Cord Blood, Peripheral Blood, and the Bone Marrow
White Paper September 2016 CD34+ Cells: A Comparison of Stem and Progenitor Cells in Cord Blood, Peripheral Blood, and the Bone Marrow Lily C. Trajman, PhD Introduction: Hematopoietic Stem Cells (HSCs)
More informationDr.PSRK.Sastry MD, ECMO
Peripheral blood stem cell transplantation (Haematopoietic stem cell transplantation) Dr.PSRK.Sastry MD, ECMO Consultant, Medical Oncology Kokilaben Dhirubhai Ambani Hospital Normal hematopoiesis Historical
More informationXIV. HLA AND TRANSPLANTATION MEDICINE
XIV. HLA AND TRANSPLANTATION MEDICINE A. Introduction 1. The HLA system includes a complex array of genes and their molecular products that are involved in immune regulation and cellular differentiation.
More information5/9/2018. Bone marrow failure diseases (aplastic anemia) can be cured by providing a source of new marrow
5/9/2018 or Stem Cell Harvest Where we are now, and What s Coming AA MDS International Foundation Indianapolis IN Luke Akard MD May 19, 2018 Infusion Transplant Conditioning Treatment 2-7 days STEM CELL
More informationTransplant Booklet D Page 1
Booklet D Pretest Correct Answers 4. (A) is correct. Technically, performing a hematopoietic stem cell transplant is one of the simplest transplantation procedures. The hematopoietic stem cells are infused
More informationChemotherapeutic Susceptibility of Human Bone Marrow Progenitor Cells and Human Myelogenous Leukemia Cells (HMO) in Co-Culture: Preliminary Report
International Journal of Cell Cloning 2: 254-262 (1984) Chemotherapeutic Susceptibility of Human Bone Marrow Progenitor Cells and Human Myelogenous Leukemia Cells (HMO) in Co-Culture: Preliminary Report
More informationProduction of the Formed Elements (Chapter 11) *
OpenStax-CNX module: m62120 1 Production of the Formed Elements (Chapter 11) * Ildar Yakhin Based on Production of the Formed Elements by OpenStax This work is produced by OpenStax-CNX and licensed under
More informationFeasibility of hyperthermia as a purging modality in autologous bone marrow transplantation Wierenga, Pieter Klaas
University of Groningen Feasibility of hyperthermia as a purging modality in autologous bone marrow transplantation Wierenga, Pieter Klaas IMPORTANT NOTE: You are advised to consult the publisher's version
More informationCHAPTER 3 LABORATORY PROCEDURES
CHAPTER 3 LABORATORY PROCEDURES CHAPTER 3 LABORATORY PROCEDURES 3.1 HLA TYPING Molecular HLA typing will be performed for all donor cord blood units and patients in the three reference laboratories identified
More informationWhat s a Transplant? What s not?
What s a Transplant? What s not? How to report the difference? Daniel Weisdorf MD University of Minnesota Anti-cancer effects of BMT or PBSCT [HSCT] Kill the cancer Save the patient Restore immunocompetence
More informationIntroduction to Hematopoietic Stem Cell Transplantation
Faculty Disclosures Introduction to Hematopoietic Stem Cell Transplantation Nothing to disclose Jeanne McCarthy-Kaiser, PharmD, BCOP Clinical Pharmacist, Autologous Stem Cell Transplant/Long- Term Follow-Up
More informationPatient Input CADTH COMMON DRUG REVIEW
CADTH COMMON DRUG REVIEW Patient Input LETERMOVIR (PREVYMIS) (Merck Canada Inc.) Indication: Text Indicated for the prophylaxis of cytomegalovirus (CMV) infection or disease in adult CMV-seropositive recipients
More informationDedicated to Gordon. Stem Cell Transplantation: The Journey
Dedicated to Gordon Stem Cell Transplantation: The Journey 1949 Jacobson et al: Radioprotection by lead shielding of the spleen of a lethally irradiated animal 1951 Lorenz et al: Radiation protection
More informationBone Marrow Transplantation and the Potential Role of Iomab-B
Bone Marrow Transplantation and the Potential Role of Iomab-B Hillard M. Lazarus, MD, FACP Professor of Medicine, Director of Novel Cell Therapy Case Western Reserve University 1 Hematopoietic Cell Transplantation
More informationHematopoiesis. - Process of generation of mature blood cells. - Daily turnover of blood cells (70 kg human)
Hematopoiesis - Process of generation of mature blood cells - Daily turnover of blood cells (70 kg human) 1,000,000,000,000 total cells 200,000,000,000 red blood cells 70,000,000,000 neutrophils Hematopoiesis
More informationCarol Cantwell Blood Transfusion Laboratory Manager St Mary s Hospital, ICHNT
Carol Cantwell Blood Transfusion Laboratory Manager St Mary s Hospital, ICHNT History Why is blood transfusion involved? What tests are performed in blood transfusion and why? What does a protocol look
More informationEarly reconstitution of haematopoiesis after allogeneic bone marrow transplantation: a prospective histopathological study of bone
J Clin Pathol 199;43:365-369 Departments of Paediatrics and Pathology, Leiden University Hospital, PO Box 96, 23 RC Leiden, The Netherlands H van den Berg Ph M Kluin J M Vossen Correspondence to: Dr H
More informationMyelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data
Instructions for Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data (Form 2114) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Myelodysplasia/Myeloproliferative
More informationT cell manipulation of the graft: Yes
T cell manipulation of the graft: Yes J.H. Frederik Falkenburg Department of Hematology L M U C Allogeneic Hematopoietic Stem Cell Transplantation (SCT) for non-malignant disorders: no need for anti-tumor
More informationThe future of HSCT. John Barrett, MD, NHBLI, NIH Bethesda MD
The future of HSCT John Barrett, MD, NHBLI, NIH Bethesda MD Transplants today Current approaches to improve SCT outcome Optimize stem cell dose and source BMT? PBSCT? Adjusting post transplant I/S to minimize
More informationOverview of Aplastic Anemia. Overview of Aplastic Anemia. Epidemiology of aplastic anemia. Normal hematopoiesis 10/6/2017
Overview of Aplastic Anemia Overview of Aplastic Anemia Peter Westervelt, MD, PhD Professor of Medicine Chief, BMT/Leukemia Section Washington University School of Medicine Epidemiology Normal hematopoiesis
More informationThe National Marrow Donor Program. Graft Sources for Hematopoietic Cell Transplantation. Simon Bostic, URD Transplant Recipient
1988 199 1992 1994 1996 1998 2 22 24 26 28 21 212 214 216 218 Adult Donors Cord Blood Units The National Donor Program Graft Sources for Hematopoietic Cell Transplantation Dennis L. Confer, MD Chief Medical
More informationIndex. endocytosis, 92 fat cells, 99 myelofibrosis, 390 nerves, 99, 100 sinuses, 90 Bone marrow fatty involution, red and yellow marrow,
A Adherent layer cell types, 256 adipocytes, 261 endothelial cells, 259-261 function, 262, 263 interactions, 261, 262 macrophage and epitheloid cell, 256-259 Association of hematopoiesis and bone formation,209,210
More informationDr. Yi-chi M. Kong August 8, 2001 Benjamini. Ch. 19, Pgs Page 1 of 10 TRANSPLANTATION
Benjamini. Ch. 19, Pgs 379-399 Page 1 of 10 TRANSPLANTATION I. KINDS OF GRAFTS II. RELATIONSHIPS BETWEEN DONOR AND RECIPIENT Benjamini. Ch. 19, Pgs 379-399 Page 2 of 10 II.GRAFT REJECTION IS IMMUNOLOGIC
More informationClinical Policy: Donor Lymphocyte Infusion
Clinical Policy: Reference Number: PA.CP.MP.101 Effective Date: 01/18 Last Review Date: 11/16 Coding Implications Revision Log This policy describes the medical necessity requirements for a donor lymphocyte
More informationAdult Acute leukemia. Matthew Seftel. August
Adult Acute leukemia Matthew Seftel August 21 2007 mseftel@cancercare.mb.ca Principles 3 cases Diagnosis and classification of acute leukemia (AL) Therapy Emergencies Remission induction BMT Complications
More informationCorporate Medical Policy
Corporate Medical Policy Hematopoietic Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_cell_transplantation_for_cll_and_sll 2/2001
More informationTransition from active to palliative care EBMT, Geneva, Dr. med. Gayathri Nair Division of Hematology
Transition from active to palliative care EBMT, Geneva, 03.04.2012 Dr. med. Gayathri Nair Division of Hematology 3 cases of patients who underwent an allogeneic stem cell transplantation in curative intent
More informationHematopoietic Growth Factors Colony Stimulating Factors. Erythropoietin (Epoetin alfa). Granulocyte-macrophage colonystimulating factor (G-CSF).
Hematopoietic Growth Factors Colony Stimulating Factors. Erythropoietin (Epoetin alfa). Granulocyte colony-stimulating factor(g-csf). Granulocyte-macrophage colonystimulating factor (G-CSF). Interleukin-11
More informationABO INCOMPATILIBITY AND TRANSPLANTATION
ABO INCOMPATILIBITY AND TRANSPLANTATION Aleksandar Mijovic Consultant Haematologist/Senior Lecturer King s College Hospital/NHS Blood and Transplant London, UK RTC Edu Meeting May 2017 ABO antigens Expressed
More informationBone Marrow Transplantation in Myelodysplastic Syndromes. An overview for the Myelodysplasia Support Group of Ottawa
Bone Marrow Transplantation in Myelodysplastic Syndromes An overview for the Myelodysplasia Support Group of Ottawa Objectives Provide brief review of marrow failure Re emphasize the importance of predictions
More informationHaplo vs Cord vs URD Debate
3rd Annual ASBMT Regional Conference for NPs, PAs and Fellows Haplo vs Cord vs URD Debate Claudio G. Brunstein Associate Professor University of Minnesota Medical School Take home message Finding a donor
More informationGetting to the root of Cancer
Cancer Stem Cells: Getting to the root of Cancer Dominique Bonnet, Ph.D Senior Group Leader, Haematopoietic Stem Cell Laboratory Cancer Research UK, London Research Institute Venice, Sept 2009 Overview
More informationStem Cell Transplantation for Severe Aplastic Anemia
Number of Transplants 10/24/2011 Stem Cell Transplantation for Severe Aplastic Anemia Claudio Anasetti, MD Professor of Oncology and Medicine Chair, Blood and Marrow Transplant Dpt Moffitt Cancer Center
More informationBone marrow is a specialized type of soft connective tissue called myeloid tissue. It serves as the site for production of
ISSN: 0975-766X CODEN: IJPTFI Available Online through Research Article www.ijptonline.com BONE MARROW TRANSPLANTATION Powar P. V*, Ms.Tiwari.D.J, Dr. Sharma P. H Department of Pharmaceutics, Padmashree
More informationHealth Sciences 1111 Module 11 Blood and Lymphatics LAB 11. Watch the video Our Immune System and answer the questions on your worksheet.
Health Sciences 1111 Module 11 Blood and Lymphatics LAB 11 Watch the video Our Immune System and answer the questions on your worksheet. Open Internet Explorer o Go to the Health Sciences Website* and
More informationEffect of Interleukin 10 on the Hematopoietic Progenitor Cells from Patients with Aplastic Anemia
Effect of Interleukin 10 on the Hematopoietic Progenitor Cells from Patients with Aplastic Anemia YOSHINOBU ASANO, SHOICHIRO SHIBATA, SHINJI KOBAYASHI, SEIICHI OKAMURA, YOSHIYUKI NIHO First Department
More informationHaploidentical Transplantation: The Answer to our Donor Problems? Mary M. Horowitz, MD, MS CIBMTR, Medical College of Wisconsin January 2017
Haploidentical Transplantation: The Answer to our Donor Problems? Mary M. Horowitz, MD, MS CIBMTR, Medical College of Wisconsin January 2017 Allogeneic Transplant Recipients in the US, by Donor Type 9000
More informationAn Overview of Blood and Marrow Transplantation
An Overview of Blood and Marrow Transplantation October 24, 2009 Stephen Couban Department of Medicine Dalhousie University Objectives What are the types of blood and marrow transplantation? Who may benefit
More informationBMTCN Review Course Basic Concepts and Indications for Transplantation How the Experts Treat Hematologic Malignancies Las Vegas, NV, March 10, 2016
BMTCN Review Course Basic Concepts and Indications for Transplantation How the Experts Treat Hematologic Malignancies Las Vegas, NV, March 10, 2016 David Rice, PhD, RN, NP Director, Professional Practice
More informationSupplemental Table 1 Multivariate analysis of neutrophil and platelet
Transplant using vs. HLA 1-AG mismatched RD Supplemental Table 1 Multivariate analysis of neutrophil and platelet engraftment Variable Neutrophil engraftment* Platelet engraftment HR (95% CI) P value HR
More informationFILE - STEM CELL TRANSPLANT FOR MDS ARCHIVE
06 February, 2018 FILE - STEM CELL TRANSPLANT FOR MDS ARCHIVE Document Filetype: PDF 497.57 KB 0 FILE - STEM CELL TRANSPLANT FOR MDS ARCHIVE Allogeneic hematopoietic stem-cell transplantation (HSCT) is
More informationAn Introduction to Bone Marrow Transplant
Introduction to Blood Cancers An Introduction to Bone Marrow Transplant Rushang Patel, MD, PhD, FACP Florida Hospital Medical Group S My RBC Plt Gran Polycythemia Vera Essential Thrombocythemia AML, CML,
More informationIn Vitro Growth of Erythropoietic Progenitor Cells in Long-%rm Remission of Acute Leukemia
International Journal of Cell Cloning 4: 186-191 (1986) In Vitro Growth of Erythropoietic Progenitor Cells in Long-%rm Remission of Acute Leukemia C. Peschel, G. Konwalinka, D. Geissler, H. Bmunsteiner
More informationIntroduction to Clinical Hematopoietic Cell Transplantation (HCT) George Chen, MD Thursday, May 03, 2018
Introduction to Clinical Hematopoietic Cell Transplantation (HCT) George Chen, MD Thursday, May 03, 2018 The transfer of hematopoietic progenitor and stem cells for therapeutic purposes Hematopoietic Cell
More informationMyeloid neoplasms. Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories:
Myeloid neoplasms Note: Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories: 1. AML : Acute myeloid leukemia(stem cell with myeloid
More informationunits with extensive capability to self-renew and generate
Proc. NatL Acad. Sci. USA Vol. 79, pp. 3843-3847, June 98 Medical Sciences Identification in culture of a class of hemopoietic colony-forming units with extensive capability to self-renew and generate
More informationCircle Yes or No Y N. (Note: requests without this information will not be accepted.) [If no, then no further questions.]
04/25/2016 Prior Authorization AETA BETTER HEALTH OF LA MEDICAID Colony Stimulating Factors (LA88) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
More informationBone Marrow Transplantation
Bone Marrow Transplantation Introduction Bone marrow is the spongy tissue inside all of your bones, including your hip and thigh bones. The bone marrow is like a factory that makes different types of blood
More informationHematopoietic Stem Cell Therapy
Hematopoietic Stem Cell Therapy Grace Totoe, MBChB, SBB CME August 2012 Accra-Ghana Hematopoietic Stem Cells Cells capable of self renewal and differentiation into all blood cell lineages Objectives Historical
More information3.1 Clinical safety of chimeric or humanized anti-cd25 (ch/anti-cd25)
3 Results 3.1 Clinical safety of chimeric or humanized anti-cd25 (ch/anti-cd25) Five infusions of monoclonal IL-2 receptor antibody (anti-cd25) were planned according to protocol between day 0 and day
More informationGraft Versus Tumour Effect
Graft Versus Tumour Effect Mairéad NíChonghaile 12 Abstract The treatment of relapsed disease remains challenging, and it is well accepted that concept of allogeneic HSCT relies upon both the conditioning
More informationEvaluation of Early Post-transplant Leukocyte Recovery Using the Undiluted Erythrocyte Lysing Technique
Annals of Clinical & Laboratory Science, vol. 32, no. 2, 2002 159 Evaluation of Early Post-transplant Leukocyte Recovery Using the Undiluted Erythrocyte Lysing Technique Myungshin Kim, 1 Ja Young Kim,
More informationRegulation of Hematopoiesis
THE YALE JOURNAL OF BIOLOGY AND MEDICINE 63 (1990), 371-380 Regulation of Hematopoiesis BRIAN R. SMITH, M.D. Departments oflaboratory Medicine, Internal Medicine, and Pediatrics, Yale University School
More informationPathology. #11 Acute Leukemias. Farah Banyhany. Dr. Sohaib Al- Khatib 23/2/16
35 Pathology #11 Acute Leukemias Farah Banyhany Dr. Sohaib Al- Khatib 23/2/16 1 Salam First of all, this tafreegh is NOT as long as you may think. If you just focus while studying this, everything will
More informationThe Changing Face of MDS: Advances in Treatment
Thank you very much again for listening to me. We are going to be talking now in terms of therapy of MDS or The Changing Face of MDS Advances in Treatment. My name is Guillermo Garcia-Manero. I am a Professor
More information2. Is therapy prescribed by, or in consultation with, a hematologist and/or oncologist?
Pharmacy Prior Authorization AETA BETTER HEALTH EW JERSE (MEDICAID) Colony Stimulating Factors (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More informationproperties of erythroid progenitor burst-forming cell
Proc. Natl. Acad. Sci. USA Vol. 8, pp. 3721-3725, June 1983 Cell Biology Isolation and induction of erythroleukemic cell lines with properties of erythroid progenitor burst-forming cell (BFU-E) and erythroid
More informationAtomic Bomb and Leukemia ICHIMARU M., TOMONAGA M., AMENOMORI T. AND MATSUO T.
Atomic Bomb and Leukemia ICHIMARU M., TOMONAGA M., AMENOMORI T. AND MATSUO T. Department of Hematology, Atomic Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan (Received December
More informationCircle Yes or Y N. [Note: requests without this information will not be accepted.] [If no, then no further questions.
10/01/2016 Prior Authorization Aetna Better Health of West Virginia COLO STIMULATIG FACTORS (WV88) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
More informationEarly Repair Processes in Marrow Cells Irradiated and Proliferating in Vivo1
RADIATION RESEARCH 18, 96-105 (1963) Early Repair Processes in Marrow Cells Irradiated and Proliferating in Vivo1 J. E. TILL AND E. A. McCULLOCH Department of Medical Biophysics, University of Toronto,
More informationProduction of the Formed Elements *
OpenStax-CNX module: m46691 1 Production of the Formed Elements * OpenStax This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of this section,
More informationStem Cells And The Future of Regenerative Medicine. Dipnarine Maharaj, M. D., FACP
Stem Cells And The Future of Regenerative Medicine Dipnarine Maharaj, M. D., FACP The following potential conflict of interest relationships are germane to my presentation. Employment: South Florida Bone
More informationAllogeneic Stem Cell Transplantation with Peripheral Blood Stem Cells Mobilized by Pegylated G-CSF
Biology of Blood and Marrow Transplantation 12:63-67 (26) 26 American Society for Blood and Marrow Transplantation 183-8791/6/126-2$32./ doi:1.116/j.bbmt.26.3.1 Allogeneic Stem Cell Transplantation with
More informationLeukine. Leukine (sargramostim) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Leukine Page: 1 of 6 Last Review Date: November 30, 2018 Leukine Description Leukine (sargramostim)
More informationHEMATOLOGIC MALIGNANCIES BIOLOGY
HEMATOLOGIC MALIGNANCIES BIOLOGY Failure of terminal differentiation Failure of differentiated cells to undergo apoptosis Failure to control growth Neoplastic stem cell FAILURE OF TERMINAL DIFFERENTIATION
More informationDone By : WESSEN ADNAN BUTHAINAH AL-MASAEED
Done By : WESSEN ADNAN BUTHAINAH AL-MASAEED Acute Myeloid Leukemia Firstly we ll start with this introduction then enter the title of the lecture, so be ready and let s begin by the name of Allah : We
More informationTransplantation. Immunology Unit College of Medicine King Saud University
Transplantation Immunology Unit College of Medicine King Saud University Objectives To understand the diversity among human leukocyte antigens (HLA) or major histocompatibility complex (MHC) To know the
More informationThe Role of Conventional Donor Lymphocyte Transfusions. Hans-Jochem Kolb 3rd Med. Dept. Klinikum re der Isar Technische Universitaet Muenchen Germany
The Role of Conventional Donor Lymphocyte Transfusions Hans-Jochem Kolb 3rd Med. Dept. Klinikum re der Isar Technische Universitaet Muenchen Germany Survival of Patients with Allogeneic SCT for AML CR1:
More informationSTEM CELL TRANSPLANTATION FOR ACUTE MYELOID LEUKEMIA
STEM CELL TRANSPLANTATION FOR ACUTE MYELOID LEUKEMIA Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan.
More informationMUD HSCT as first line Treatment in Idiopathic SAA. Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK
MUD HSCT as first line Treatment in Idiopathic SAA Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK No Financial Disclosures Guidelines for management of aplastic anaemia British
More informationNiCord Single Unit Expanded Umbilical Cord Blood Transplantation: Results of Phase I/II Trials
NiCord Single Unit Expanded Umbilical Cord Blood Transplantation: Results of Phase I/II Trials Mitchell E. Horwitz, MD Duke University Medical Center Duke Cancer Institute Adult Umbilical Cord Blood Transplantation
More informationAllogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms. Policy Specific Section:
Medical Policy Allogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Type: Medical Necessity and Investigational / Experimental Policy Specific Section:
More informationHighly Efficient CRISPR/Cas9 Gene Editing and Long-Term Engraftment of Human Hematopoietic Stem and Progenitor Cells
Highly Efficient CRISPR/Cas9 Gene Editing and Long-Term Engraftment of Human Hematopoietic Stem and Progenitor Cells J. M. Heath, A. Chalishazar, C.S. Lee, W. Selleck, C. Cotta-Ramusino, D. Bumcrot, J.L.
More informationUMBILICAL CORD BLOOD STEM CELLS EXPANDED IN THE PRESENCE OF NICOTINAMIDE (NICORD) PROVIDE LONG TERM MULITI-LINEAGE ENGRAFTMENT
UMBILICAL CORD BLOOD STEM CELLS EXPANDED IN THE PRESENCE OF NICOTINAMIDE (NICORD) PROVIDE LONG TERM MULITI-LINEAGE ENGRAFTMENT Mitchell E. Horwitz, MD Duke University Medical Center Duke Cancer Institute
More informationReduced-intensity Conditioning Transplantation
Reduced-intensity Conditioning Transplantation Current Role and Future Prospect He Huang M.D., Ph.D. Bone Marrow Transplantation Center The First Affiliated Hospital Zhejiang University School of Medicine,
More informationAppendix 6: Indications for adult allogeneic bone marrow transplant in New Zealand
Appendix 6: Indications for adult allogeneic bone marrow transplant in New Zealand This list provides indications for the majority of adult BMTs that are performed in New Zealand. A small number of BMTs
More informationDEPARTMENT OF CLINICAL HEMATOLOGY
DEPARTMENT OF CLINICAL HEMATOLOGY What is blood? Blood is the vital fluid of the body, which performs diverse functions from delivering oxygen to each and every cell of the body to fighting against infections
More informationG-CSF-primed autologous and allogeneic bone marrow for transplantation in clinical oncology. Cell content and immunological characteristics
Journal of Physics: Conference Series PAPER OPEN ACCESS G-CSF-primed autologous and allogeneic bone marrow for transplantation in clinical oncology. Cell content and immunological characteristics To cite
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_ transplantation_for_primary_amyloidosis 2/2001 11/2018 11/2019 11/2018 Description
More informationSUPPLEMENTARY INFORMATION
a. Smo+/+ b. Smo+/+ 5.63 5.48 c. Lin- d. e. 6 5 4 3 Ter119 Mac B T Sca1 Smo+/+ 25 15 2 o BMT 2 1 5 * Supplementary Figure 1: Deletion of Smoothened does not alter the frequency of hematopoietic lineages
More informationInternational Journal of Cell Cloning 6: (1988) Research Laboratory of Blood Physiology, Hunan Medical College, Changsha, Hunan, PRC
Original Paper International Journal of Cell Cloning 6:290-295 (1988) The Influence of Histamine at Various Concentrations on the Cell Cycle State of Hematopoietic Stem Cells (CF'U-s) I"i Shounan, XU You-Heng
More informationThe role of HLA in Allogeneic Hematopoietic Stem Cell Transplantation and Platelet Refractoriness.
The role of HLA in Allogeneic Hematopoietic Stem Cell Transplantation and Platelet Refractoriness. Robert Liwski, MD, PhD, FRCPC Medical Director HLA Typing Laboratory Department of Pathology Dalhousie
More informationTransplantation - Challenges for the future. Dr Gordon Cook S t James s Institute of Oncology, Leeds Teaching Hospitals Trust
Transplantation - Challenges for the future Dr Gordon Cook S t James s Institute of Oncology, Leeds Teaching Hospitals Trust Bone Marrow Transplantation Timeline, 1957-2006 Appelbaum F. N Engl J Med 2007;357:1472-1475
More informationD Bonnet 1,2, M Bhatia 1,3, JCY Wang 1, U Kapp 1 and JE Dick 1. Summary:
Bone Marrow Transplantation, (1999) 23, 203209 1999 Stockton Press All rights reserved 02683369/99 $12.00 http://www.stockton-press.co.uk/bmt Cytokine treatment or accessory cells are required to initiate
More informationDifferentiation of Subpopulations of Human and
Differentiation of Subpopulations of Human and Murine Hemopoietic Stem Cells by Hypotonic Lysis EERo NISKANEN and MARTIN J. CLINE, Division of Hematology-Oncology, Department of Medicine, University of
More information