What are the three requirements for a hematopoietic stem cell transplant?

1. It is necessary to find a suitable match, because the probability of HLA (human leukocyte antigen) matching is very low, even if it is a sibling, it is only 1 4, so although the establishment of a bone marrow bank is usually used in the world to find a matching donor in the non-blood relationship, the probability of compatibility is 1 in 1,000 to 1 in 10,000. In fact, the vast majority of patients cannot find a suitable ligand, and the disease is delayed because of this.

2. Amazing surgical costs, if the patient is lucky to find a suitable ligand, he also needs to prepare the surgical fee, the general cost of hologenetic transplantation between relatives is about 150,000 yuan, and the Chinese bone marrow bank is 25-300,000 yuan. 300,000-400,000 haploidentical transplants between relatives.

3. Radiotherapy and chemotherapy, if the patient is fortunate to have the above conditions and pass the first two hurdles, he will also face three problems, namely, the blow of radiotherapy and chemotherapy, the infection of pathogenic microorganisms, and the rejection of the body. Any one of these problems can put a patient to the test of life and death, and only 60 to 70% of patients can get through these three hurdles.

It is a pre-transplant treatment. This is a measure taken to enable the recipient to accept foreign hematopoietic stem cells and to reduce the burden on their own tumor cells, and the classic regimen is cyclophosphamide 60 mg kg body weight taken for 3 days plus 8 12 gray of one or divided total body irradiation. This scheme is more damaging to the patient, and is mostly used for patients who are in good health, younger in age, have a shorter course of disease, and have good function of major organs.

In order to make hematopoietic stem cell transplantation available to children and older, weaker patients, there is a modification of the classic regimen described above, called nonmyeloablative bone marrow transplant pretreatment, usually by reducing the amount and dose of cytotoxic drugs used, with no or reduced total body irradiation dose. This is relatively safe for patients. 2 Yes, the recipient and donor should have a matching human leukocyte antigen (HLA) system.

It exists on the sixth pair of chromosomes in humans, and doctors call it the HLA-A, B, C, and DR loci, and the HLA-DR loci are particularly related to the success of the transplant, and they must be compatible, so that the chance of success is large and the risk is relatively small.

It is necessary to have a certain number of hematopoietic stem cells. It is not difficult to understand this, since as a seed cell, it is necessary to go to the new "soil" environment suitable for it to take root, germinate, flower and bear fruit, it will not be smooth sailing, and the process will be lost, and it will not work without a certain number. These are mainly for allogeneic hematopoietic stem cell transplantation.

It gives transplant patients a chance of survival, but at the same time is limited by barriers and conditions that lurk at risk, such as complications such as bleeding, infection, rejection, host-versus-host disease, and hepatic vein embolism. However, with the continuous innovation of science and technology, the gradual improvement of imperfections, the gradual recognition of those who have not been recognized, and the more and more experienced, it is believed that more and more patients will receive reasonable treatment and regain their health.

Theoretically, there is no health effect on the body, but in practice there is ***. This effect is present during surgery and blood drawing. According to foreign studies, about 51,024 hematopoietic stem cell heterologous transplants were completed, of which 27,770 were bone marrow transplants and 23,254 were peripheral blood transplants.

Of these 51,024 donors, 5 donors died, including 1 case of Tangerine Ant who died after bone marrow donation and 4 cases died of peripheral blood donation, with a mortality rate of about 10,000 people. There were 37 cases of serious adverse reactions, with a chance of causing illness in about 10,000 people, of which 12 were after bone marrow transplantation (10,000 people) and 25 were after peripheral blood transplantation (10,000 people). In addition, about 20 donors developed malignant hematologic tumors (10,000 people), including 8 donors after bone marrow transplantation and 12 donors after peripheral blood stem cell donation.

The incidence of malignant hematologic tumors is not higher than that of normal age- and sex-related pathogenesis.

Conclusion: There may be a risk of lethality or serious adverse reactions in the donation of bridge-building blood stem cells, which is small but does exist. The human body is a very complex and wonderful organism, and current science is unclear about many functions and mechanisms.

Hematopoietic stem cells are the most mysterious cells, and the onset of leukemia is the result of various factors interfering with it. The collection of hematopoietic stem cells currently requires human interference, so unless science and technology are developed in the future, the collection will be quiet, and it will not interfere with the hematopoietic function at all, and a very small part will be collected from the body, which will be eliminated.

The indications for autologous shed blood stem cell transplantation are briefly reviewed.

A:(1) effective consolidation measures after complete remission of acute leukemia;

2) Hodgkin lymphoma and non-Hodgkin lymphoma are the most common diseases of autologous hematopoietic stem cell transplantation;

3) Chronic myeloid leukemia.

4) Breast cancer is the most common case of solid tumors.

Teacher Han Wangchen's lecture ideas are clear and humorous, I like you too much to let Tongmo teach the state of class, it is impossible for people to get distracted, the more you listen, the more you love to listen!

The exam is coming up in April, and I have applied for "Advanced Mathematics (I)" and "Introduction Rate and Mathematical Statistics (Economics and Management)", and I want to study hard with my teacher to win the first "hard battle" of the Year of the Horse.

Briefly describe the classification of hematopoietic stem cell transplantation. A:autologous transplantation; Allogeneic transplantation is further divided into sibling donor transplantation and non-blood donor transplantation; Homogeneic transplantation is a transplant of the recipient and the donor's genes that are identical, and in humans it refers only to the transplantation between identical twins.

Teacher Han Wangchen has a clear and humorous lecture idea, I like the state of your lecture so much, it is impossible for people to be distracted, the more you listen, the more you love to listen!

The exam is coming up in April, and I have applied for "Advanced Mathematics (I)" and "Introduction Rate and Mathematical Statistics (Economics and Management)", and I want to study hard with my teacher to win the first "hard battle" of the Year of the Horse.

Hematopoietic stem cell transplantation mainly includes bone marrow transplantation, peripheral blood stem cell transplantation, and umbilical cord blood stem cell transplantation.

Because bone marrow is a hematopoietic organ, bone marrow transplantation was performed in the early stages.

In 1958, the French oncologist Mathe first performed a bone marrow transplant on a patient who had been injured by a radiation accident.

In 1968, GATTI successfully applied bone marrow transplantation to a severe combined immunodeficiency patient.

After the 70s of the last century, with the discovery of human leukocyte antigen (HLA), the progress of blood products and antibiotics, the protection of the environment and the wide application of hematopoietic growth factors, hematopoietic stem cell transplantation technology has developed rapidly.

In 1977, Thomas reported that 13 of 100 patients with advanced leukemia had miraculously survived long lives after bone marrow transplantation from HLA-matched siblings.

Since then, the world has achieved great success in the application of bone marrow transplantation for leukemia, aplastic anemia and other serious blood diseases, acute radiation sickness and some malignant tumors, creating a new era of clinical leukemia and malignant tumors.

Generally speaking, there are three parts of our human body that produce and store hematopoietic stem cells, the first part is the bone marrow, which stores most of the body's hematopoietic stem cells, and this part of the hematopoietic stem cells is called bone marrow hematopoietic stem cells. There is also a part of peripheral blood (that is, peripheral venous blood outside the bone marrow), that is, there is a small amount of hematopoietic stem cells in the blood vessels, which we call peripheral blood hematopoietic stem cells. The third is that there are a large number of abundant hematopoietic stem cells in the umbilical cord blood of newborns, which we call cord blood stem cells.

Therefore, hematopoietic stem cell transplantation includes a wider range, in addition to bone marrow transplantation, hematopoietic stem cell transplantation also includes peripheral blood hematopoietic stem cell transplantation and umbilical blood hematopoietic stem cell transplantation. We now advocate the use of hematopoietic stem cells from peripheral blood for collection.

First, the reference is different.

1. Bone marrow transplantation: It is a method of rebuilding the patient's normal hematopoietic and immune system through intravenous infusion of hematopoietic stem and progenitor cells, thereby leading to a series of diseases.

2. Hematopoietic stem cell transplantation: patients first receive ultra-high-dose radiotherapy or chemotherapy (usually lethal doses of chemoradiotherapy), sometimes combined with other immunosuppressive drugs, to remove tumor cells and abnormal clonal cells in the body, and then infuse back hematopoietic stem cells collected from themselves or others to rebuild normal hematopoietic and immune function.

Second, the characteristics are different.

1. Bone marrow transplantation: The use of pretreatment protocols can create space, immunosuppression, and clear the disease. The strength of the pretreatment regimen is aimed at preventing transplant rejection to the greatest extent and achieving the patient's tolerance to it, so there are a variety of pretreatment regimens to choose from.

2. Hematopoietic stem cell transplantation: hematopoietic stem cell transplantation from blood relations donors and hematopoietic stem cell transplantation from unrelated donors (i.e., unrelated transplantation); According to the type of graft, it is divided into peripheral blood hematopoietic stem cell transplantation, bone marrow transplantation and umbilical cord blood hematopoietic stem cell transplantation.

Third, the development is different.

1. Bone marrow transplantation: With the improvement of transplantation technology, its efficacy has gradually stabilized. Difficulties in the selection of transplant donors are a major obstacle to transplantation.

The application of HLA incomplete compatible relatives donors, HLA haploid matched relatives donors and unrelated donors and related technical improvements have become hot topics in clinical research, and non-myeloablative techniques have also brought about a conceptual revolution.

2. Hematopoietic stem cell transplantation: There are many advanced drugs for these patients from the genetic level, but allogeneic hematopoietic stem cell transplantation is still the only means for these diseases.