A brief presentation on Bone Marrow Transplant in Oncology by S K Rezaul, proudly presented by Biomedicz (www.biomedicz.com).

1. Bone Marrow Transplant in
Oncology
SK REJAUL
DEPARTMENT OF BIOMEDICAL ENGINEERING
NETAJI SUBHASH ENGINEERING COLLEGE

2. Source

3. Pathology
 Treat Leukemia by chemotherapy
 Regeneration of normal marrow
 Chemotherapy alone cannot eliminate
all malignant cells
 Stem cell transplants.

4. Transplant
 Patient's bone marrow stem cells are
replaced with healthy cells
 Existing bone marrow and abnormal
leukocytes killed
 Chemotherapy and radiation
 Next bone marrow containing healthy
stem cells re-infused

5. Procedure
 Bone Marrow versus Peripheral Stem
Cells
 Accessibility
 Cost
 Sample size
 Donor/Patient factors
 Expertise

6. Adult Stem Cell Transplant

7. Procedure
 Most blood stem cells reside in the
bone marrow and a small number are
present in the bloodstream
 Multipotent peripheral blood stem
cells
 Can be obtained from drawn blood
 PBSCs are easier to collect than bone
marrow stem cells

8. Harvesting

9. Umbilical Cord Blood Stem Cell
Transplant
 Umbilical cords have traditionally
been discarded as a by-product of the
birth process.
 Pluripotent-stem-cell-rich blood found
in the umbilical cord rich in marrow
stem cells and PBSC’s.

10. Umbilical Cord Tx
 Umbilical cord transplants are less
prone to rejection.
 Cells have not yet developed the
features that can be recognized and
attacked by the recipient's immune
system.
 Umbilical cord blood lacks well-
developed immune cells, there is
smaller incidence of graft versus host
disease.

11. Cord Blood

12. THE FUNCTION OF BMT UNIT
Handling services & Intensive care
for:
 Mobilization / stem cell collection &
infusion.
 Chemotherapy for pre - transplant
 Pre & post care for Transplant
patients.

13. Transplantation
 Autologous
 Allogeneic
 Syngeneic

14. Indications
 Hematological diseases
Benign : Thallassaemia, Aplastic
Anaemia
Malignant : Leukemia Lymphoma
Myeloma
 Immune deficiency disorders
Pediatric and Adult
 Neurological Disease (MS)

15. Auto Transplant

16. Recovering from the transplant
 Recovery of normal levels cells is called
engraftment
 Day 8 - 12
 Neutrophil engraftment important (GCSF)
may be given to accelerate the process
 Platelets are the next to return with red
cells last.
 Commonly patients require transfusion of
red cells and platelets following a
transplant.
 Discharge upon neutrophil & platelet
engraftment

17. Allotransplant

18. Graft Verses Host Disease
(GVHD)
 GVHD sometimes occurs with allogeneic
transplantation.
 Lymphocytes from the donor graft attack the cells of
the host
 GVHD can usually be treated with steroids or other
immunosuppressive agents.
 Acute GVHD occurs before day 100 post-transplant
 Chronic GVHD occurs beyond day 100
 Recent advances have reduced the incidence and
severity of this post-transplant complication, but
GVHD, directly or indirectly, still accounts for
approximately 15% of deaths in stem cell transplant
patients
 Chronic GVHD can develop months or even years
post-transplant

19. GVHD
 Skin/Hair
Rash, scleroderma, lichenoid skin changes, dyspigmentation,alopecia
 Eyes
Dryness, abnormal Schirmer's Test, cornealerosions, conjunctivitis
 Mouth Atrophic changes, lichenoid changes, mucositis,ulcers, xerostomia, dental
caries
 Lungs
Bronchiolitis obliterans
 GI tract
Esophageal involvement, chronic nausea/vomiting, chronic diarrhea,
malabsorption, fibrosis, abdomina l pain/cramps
 Liver
Abnormal LFTs, biopsy abnormalities
 Genitourinary
Vaginitis, strictures, stenosis, cystitis
 Musculoskeletal
Arthritis, contractures, myositis, myasthenia, fascities
 Hematologic
Thrombocytopenia, eosinophilia, autoantibodies

20. Transplantation
 Unit is important
 Expertise
 Facility
Isolation
Phoresis
Platelet and blood support
Motivated patient

21. Problems
 Intensive process that consumes
resources
 HIV
 Donor registry limited
 Other health care priorities