Stem cell transplantation

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Stem cell transplantation
Present By ???????????? ??????
4211011 ????????? ?????????????
4211038 ??????????? ??????? 4211100
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sign symptom
- pallor - easy bruising - petechiae
ecchymosis - bleeding gum - spleen not enlarge
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sign symptom
cont
pallor - anemia - blood loss easy
bruising ecchymosis - platelet dysfunction -
capillary disorder
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Laboratory data
CBC -Normochromic normocyticanemia - Hct
20 - WBC count 2x109
/L - platelet count 20x109/L WBC
differential - lymphocyte 90 -
neutrophil 9 - monocyte
1 The corrected reticulocyte count 1.1
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Diagnosis from lab DATA
Hct (????????? red blood cell ) WBC
count Platelet count
" PANCYTOPENIA "
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DDx of pancytopenia
- Anemia - Leukemia - Myelodysplastic syndrome (
MDS) - Myelophthisis - Myelofibrosis
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Bone marrow aspiration
- Hypocellularity ( lt 5 ) - Lymphocyte - No
stem cell blast cell - No
megakaryocyte
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Diagnosis from CBC and BM biopsy
- Aplastic anemia - Leukemia - MDS -
Myelophthisis - Myelofibrosis
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(No Transcript)
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Bone marrow transplantation
Autologous BMT Allogenic BMT
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Allogenic BMT
HLA-compatible
cyclophosphamide 35 days after BMT one about
GVHD cyclosporin NO GVHD
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Laboratory DATA (after BMT)
CBC - Hct 45 - WBC
count 6 x109/L - platelet count
210x109/L WBC differential - Neutrophil
71 - Lymphocyte 21 - Monocyte
6 - Eosinophil 2
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Bone Marrow Biopsy
- A bone marrow cellularity of 50 - Stem
cell - Mature cell normal
Symptom - No GVHD - No bleeding - No infection
successful in BMT
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Complication ??????? BMT
1 .Early Complication
- Chemotheraphy and radiation toxicity -
Graft rejection - Graft Versus Host Disease -
Immune deficiency - Infection - Interstitial
pneumonitis
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2 .Late Complication
late effect ??? chemoradiotherapy ???
pulmonary complication ,head and neck
complication ,gonadal function ???????????????????
???????? - chronic GVHD - secondary malignancy ,
adenocarcinoma of rectum
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Advantage
1. ???????????????????????? 2.
??????????????????????????? 3.
????????????????????????????????
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Disadvantage
1. ????????????????? 2. ?????????????????
????????????????????? 3. ?? cell ????? HLA
compatible ??????