Bone Marrow Transplantation

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Bone Marrow Transplantation
The transfer of living cells, tissues, or
organs from a donor to a recipient, with the
intention of maintaining the functional integrity
of the transplanted material in the recipient
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Just Names

• E.Donall Thomas
• George Santos
• vanBekkum
• George Mathe

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Indications

• Acute and chronic leukemias
• Aplastic anemia
• Congenital immunodeficiency diseases
• Lymphomas
• Metabolic disease of childhood
• Myelodisplasia
• Thalassemia

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Donor Limitations

• 25 30 of patients have an HLA-identical
  sibling.
• Marrow procured from unrelated living donor
• Marrow procured from related HLA-identical or HLA
  non identical living donor
• Autologous transolantation(marroe procured during
  remession)

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Recipient preparation

• Cyclophosphamide 60 mg/kg/day
• During two days and Toal body irradiation
• Busulfan 4mg/kg/day for fur days and
  Cyclophosphamide without irradiation
• Etoposide ,Cyarabine as a maximizer antitumor
  properties,myeloblation,immunosuppression

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Transplantation Procedure
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Anesthesic Management

• Intravenouse anesthesia sould be procured.
• Intravenouse Thiopental,Fentanyl,Vecuronium can
  be used in common doses
• Maintanance can be provide with Propofol and
  Isoflurane.

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Nota Bene
Nitrouse Oxide should be avoided as an
inactivator of Vit B12 wich is an essential
coenzyme for methionine synthetase.This enzyme
facilitate the conversion of homocystine and
methyltetehydrofolate to methionine are essential
for deoxyribonucleic acid (DNA) synthesis.
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Complications

• Rejection by hte host of the marow graft
• Acute graft-vs,-host disease (GVHD)
• Infections
• Chronic GVHD
• Prolonged immunodeficiency
• Disease recurrence

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Eugene Yevstratov MD Zacarias C.Vargas MD

• The End.