Allogeneic transplantation

B. Ph+ ALL—allogeneic transplant if donor available otherwise, IFN and Ara-C as below... 

Transplantation entails the transfer of living cells/tissue/organs from a donor to a recipient. In some cases (e.g. many skin grafting procedures) the donor and recipient are actually the same individual, and this is termed autologous transplantation. More usually, however, the donor and recipient are different individuals, and this is termed allogeneic transplantation. 

Allogeneic Transplant The person giving the bone marrow or stem cells is a genetically matched family member (usually a brother or sister). 

Unrelated Allogeneic Transplant The person donating marrow is unrelated to the patient. 

SCT includes autologous and allogeneic transplants and the choice is dependent on the end result desired as well as the risks and benefits of each procedure. Autologous transplants after immunoablative therapy function on the premise of T-cell suppression versus clonal deletion as a cause of tolerance induction in autoimmunity. 

Mobilised peripheral blood stem cells are used as the source of stem cells for transplantation, moreover most allogeneic transplants now utilize peripheral blood rather than bone marrow A variety of mobilisation regimes are used but granulocyte colony-stimulating factor (G-CSF) is the most frequently In some cases G-CSF treatment of volunteers is involved researches ... 

Cutler C, Antin JH. Peripheral blood stem cells for allogeneic transplantation a review. Stem Cells. 2001 19 108-117. 

The medical equipment of this subdivision enables providing the whole complex of measures necessary for implementation of autologous and allogeneic transplantations and correction of post-transplantation complications, including the reanimation and intensive therapy, and hemodialysis. 

HSC transplantations of peripheral blood were carried out in the Kyiv center of bone marrow transplantation during 2001-2005. That includes 2001 -30 transplantations, 2002 - 46, 2003 - 36, 2004 - 32, and 2005 - 30. Most of the transplantations were autologous. One allogeneic transplantation from relative donors was successfully carried out each 2003, 2004 and 2005. 

The final chapter comprises two reports on clinical haematopoietic stem cell transplantation (HSCT). Viktor Khomenko shares the experience of the Kiev center for stem cell transplantation. The final article in this book by Axel Zander and colleagues summarises data with the use of Antithymocyte globuline (ATG) in (HLA-mismatched) allogeneic transplantation, an approach which was promoted in the Hamburg Clinic for HSCT. 

Allogeneic transplants For prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants. Gengraf and A/eora/have been used in combination with azathioprine and corticosteroids. Sanc//n n nne always is to be used with adrenal corticosteroids. Sandimmune a so may be used in the treatment of chronic rejection in patients previously treated with other immunosuppressive agents. Because of the risk of anaphylaxis, reserve Sandimmune injection for patients who are unable to... 

Bone marrow transplantation, particularly allogenic transplantation, is often a treatment of choice for individuals suffering from acute or chronic leukaemia, aplastic anaemia or various stem cell-related genetic disorders (e.g. thalassaemias). 

Allogenic transplantation generally entails removal of approximately 11 of marrow from a matched donor (usually a sibling, preferably an identical twin). The recipient patient is prepared by intensive chemotherapy (or radiotherapy) to kill residual malignant marrow cells. The donated marrow cells are then administered intravenously to the patient, and they re-populate the marrow cavity. The peripheral blood count normally rises within 2-4 weeks. 

Graft-versus-host disease, however, is very common, occurring in the majority of patients who receive an allogeneic transplant. 

N., Peters, C., Aubourg, P, et al. (1995), Bone marrow-derived mesenchymal stem cells remain host-derived despite successful hematopoietic engraftment after allogeneic transplantation in patients with lysosomal and peroxisomal storage diseases. Exp. Hematol, 27(11), 1675-1681. 

In this study, the authors examined the immunomodulary functions of human MSCs by coculturing them with purified subpopulations of immune cells, and report that hMSCs alter the cytokine secretion profile of the host immune cells to induce a more antiinflammatory phenotype. The authors discuss and propose mechanisms underlying the immunomodulaiy functions of hMSCs in allogeneic transplantation. A shift from a proinflammatory environment toward an anti-inflammatory or tolerant cell environment would result in inflammation modulation, tolerance induction and reduction of allogeneic transplantation complications. 

Prophylaxis of graft rejection in kidney, liver, and heart allogeneic transplantation... 

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