Recent Developments In Allogeneic Hematopoietic Cell Transplantation

Recent Developments In Allogeneic Hematopoietic Cell Transplantation
Presentation by:Steven M Devine M.D.
Director, Blood and Marrow Transplant Program


Annual Numbers of Blood and Marrow Transplantations, 1970-2006

HEMATOPOIETIC STEM CELL TRANSPLANTS AT OSU BY CALENDAR YEAR
Indications for Hematopoietic Stem Cell Transplantation in North America
Allogeneic HSC Transplantation

Definitions

* Allogeneic
o Refers to the use of bone marrow, mobilized blood, or cord blood from a genetically different donor (family member, unrelated volunteer, banked cord blood)
* Autologous
o Refers to the use of the patients own bone marrow or mobilized blood
Allogeneic Versus Autologous Stem Cell
Benefits of Allogeneic Transplantation
Drawbacks of Allogeneic Transplantation
Who are Allogeneic Stem Cell Transplant Candidates?
Complications of Allogeneic Transplantation
Causes of Death after Transplantations Done in 2001-2006
Age of HSCT recipients
Trends in Allogeneic Transplantation
Current Challenges

* Reducing Regimen Related Toxicity
* Reducing Risk of GVHD and Rejection
* Enhancing Immune Reconstitution
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

BMT vs Conventional Tx for AML with poor risk cytogenetics

GVL in Leukemia
Considerations for allograft candidates
Stem cell sources
Summary of randomized trials comparing graft source
Cord Blood Transplantations
Reduced Intensity Stem Cell Transplantation
Allogeneic Transplantations using Reduced Intensity Conditioning by Donor Type Registered
High Intensity versus Low
GVL Effect after non-myeloablative transplantation
Transplantation Considerations in patients with AML
Balancing Regimen efficacy with toxicity
Balancing efficacy and toxicity
Reduced Intensity Allogeneic Transplantation
Considerations for allograft candidates
Acute GVHD Prophylaxis
What are the benefits of T-cell depletion?
What are the drawbacks of T-cell depletion?
Transplantation Considerations in patients with AML
Graft versus Tumor Effects
Current Challenges

* Enhancing Immune Reconstitution
* Reducing Risk of GVHD and Rejection
* Reducing Regimen Related Toxicity
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

Alternative Donor Allograft Sources
Refining Criteria for Transplantation
Clinical Research Activity in BMT

Recent Developments In Allogeneic Hematopoietic Cell Transplantation.ppt

Read more...

Immunology Presentations

Introduction to Immunology

Antibody Structure and B Cell Diversity

Antigen Recognition by T Lymphocytes

Development of B Lymphocytes

Development of T Lymphocytes

T Cell Mediated Immunity (CMI)

Immunity Mediated by B Cells and Antibodies

Defense Mechanisms of Human Host

Failure of Human Defense Mechanisms

HIV Infection and AIDS

Allergy and Hypersensitivity

Autoimmunity and Autoimmune Diseases

Case Studies in Autoimmunity

Rheumatoid Arthritis

Systemic Lupus Erythymatosus

Case Studies in Autoimmunity

Multiple Sclerosis

Myasthenia Gravis

Vaccines and Vaccination

Transplantation of Tissue and Organs

Read more...

Umbilical Cord Blood transplantation in acute leukemias

Umbilical Cord Blood transplantation in acute leukemias
Presentation by: Pablo Ramirez, M.D.
DiPersio Lab
Grand Rounds, March 2009

Topics covered are:
Clinical case
High risk cytogenetics: matched donor vs chemo
Impact of HLA mismatch on OS
Unrelated cord donor
Cord blood-derived stem cell source
First human infusion
Collection, processing and storage of UCB
Biology UCBT:
more questions than answers
Transplantation with UCB: children
Outcomes unrelated UCB vs BM: children with acute leukemia CIBMTR-USA
Probability of LFS
Transplantation with UCB: adults
Comparison between UCBT-uBMT:
European database analysis
Neutrophil recovery
Comparison between UCBT-uBMT American database analysis
Neutrophil recovery
Platelet recovery
Comparison of uBM, PB and UCB:
Conclusions from these studies and other databases
Approaches to improve rates and kinetics of engraftment
Transplantation of 2 partially HLA-matched UCB units (U of MN):
Myeloablative
Demographics
Neutrophil engraftment
Always one cord predominated: Potential contributors
GVHD
Hematologic recovery
Netrophils
Platelets
Chimerism
Higher incidence of grade II-IV aGVHD
Risk factors for TRM
Conclusions
Unresolved questions in UCBT


Umbilical Cord Blood transplantation in acute leukemias.ppt

Read more...