bone marrow transplantation (BMT)

Discussion in 'MRCS Forum' started by Lona., Jan 18, 2008.

  1. Lona.

    Lona. Guest

    Several patients varying disorders are on a list for potential bone marrow transplantation (BMT). In order to prioritize the list, which of the following is true?

    a- Marrow is highly immunogenic and easily rejected by the nonimmunosuppressed host
    b- Marrow transplantation has not been successful in the treatment of aplastic anemias
    c- Marrow transplantation has not been successful in the treatment of congenital immunodeficiency disease
    d- Marrow transplantation can be used as a successful therapy for stage IV breast cancer following high-dose chemotherapy
    e- Marrow transplantation must be performed with low-level immunosuppressions to enhance the degree of Chimerism
  2. Lona.

    Lona. Guest

    Answer: A. (Sabiston, 15/e, pp 501-502) Bone marrow cells are highly immunogenic. Successful engraftment requires he use of powerful immunosuppressants that not only permit the transplanted cells to survive the host’s immune response, but also prevent a graft-versus-host response against recipient tissues. The graft-versus-host response is the major impediment to more widespread clinical use of this technique. Despite these barriers, human bone marrow transplantation has had important clinical application in the treatment of aplastic anemias, congenital immunodeficiency diseases, and several Hematologic malignancies. Stem cell transplantation involves harvesting of a patient’s own pleuripotent bone marrow cells and subsequent reestablishment of the marrow following high-dose toxic chemotherapy for advanced cancer. This modality has been used in the treatment of recurrent breast cancer, but recent metaanalyses of the results have failed to show any significant survival benefit. In experimental models, work with bone marrow transplantation for the induction of tolerance to organ allografts has proved highly promising. This may provide a key for the development of treatment protocols in organ transplant recipients that would avoid or reduce the need for toxic systemic imunosuppressants.

Share This Page