By H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Ph.D., Gordon L. Phillips M.D., Gary Van Zant Ph.D. (auth.)
This booklet offers an creation to marrow and peripheral blood stem telephone transplantation (including twine blood transplants), emphasizing the foundations of this swiftly evolving quarter. a short historic standpoint is given and the newest advancements are mentioned. specific recognition is given to the reason and symptoms for transplantation, the choice of donors and resource of stem cells, and the separation, growth and manipulation of stem cells. crucial points of histocompatibility, preparative regimens utilized in stem phone transplantation, using hematopoietic development elements and cytokines, the pathophysiology of the graft-versus-host response, and the administration of issues are handled. This booklet may still give you the training internist, pediatrician, hematologist, and oncologist in addition to different physicians in education or in perform, physicians' assistants, nurses, and scholars with the knowledge essential to comprehend the ideas of stem phone transplantation and to incorporate transplantation within the remedy making plans quickly after a analysis has been validated. The textual content also needs to be priceless to the doctor who resumes the sufferers' care after they go back from the transplant center.
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Additional info for A Guide to Blood and Marrow Transplantation
Numerous methods are in use for the negative selection and removal of Tcells from allografts; they range from red cell rosetting, counterflow elutriation, magnetic beads and antibody/complement cytolysis. 5-3 logs), and is therefore increasingly used for this purpose. Cadaveric Marrow A cadaveric source of bone marrow is attractive in view of the fact that many patients do not have a suitable living related or unrelated donor. The availability of cadaveric marrow, which must be taken shortly after death and subsequently frozen and stored, may help alleviate this shortage.
This may permit tolerance of larger histocompatibility mismatches between donor and recipient and thus provide donors for larger numbers of patients who would otherwise not be candidates for transplant. Disadvantages of cord blood include the relatively small size of the collection and a somewhat longer time to engraftment after transplantation. Delayed engraftment does not seem to be a consequence of stem cell numbers, rather it appears to be related to ill-defined qualitative differences between cord blood and adult stem cell sources.
A second consideration is one that is optional but of growing concern and importance; namely, removal of contaminating metastatic cells by purging. It has been definitively shown that retrovirally marked tumor cells, of either solid or hematologic malignancies, can contribute to subsequent relapse when re-infused with the graft. To what extent micrometastases contribute to relapse in practice is unknown; however, as detection methods for metastatic cells increase in sensitivity, more and more harvests are being found to contain tumor cells and, therefore, are candidates for purging.
A Guide to Blood and Marrow Transplantation by H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Ph.D., Gordon L. Phillips M.D., Gary Van Zant Ph.D. (auth.)
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