Bone Marrow Transplantation

The basic transplantation procedure is actually relatively simple (3:519). Multiple bone marrow aspirations are simply taken from a donor and transfused into a recipient. For transplant engrafting to occur, the donor and recipient must be matched with respect to their major histocompatibility antigens. Thus, donors should be an identical twin (syngeneic); another closely related individual such as a sibling (allogenic); or the patient himself (autologous) (3:519).

With the exception of the syngeneic transplants (and also patients with some form of immunologic deficiency), most recipients require some form of immunosuppressive medication (7:835). The particular pharmacologic agent used will depend on the patient's underlying medical condition. For example, with nonm

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associated with significantly higher survival rates (1:19). Another acute leukemia, nonlymphocytic leukemia (ANLL), also has a poor prognosis. With chemotherapy, only about 20% of these patients survive five years. For those who receive chemotherapy and then go into remission, an ANLL relapse is almost always fatal (2:649). It has been found, however, that bone marrow transplantation early in these patients' first remission will decrease their relapse rate. Since 1979, different studies have observed that ALL and ANLL patients treated in their second remission or first remission stages respectively have survival rates of between 48% to 60% (3:519). Interestingly, it has also been found that ALL allogenic transplant recipients actually have a higher success rate (i.e., a higher proportion of longterm diseasefree survivors) than syngeneic recipients. It is thought that this is caused by graftversushost disease (GvHD) in the allogenic transplants. In fact, GvHD occurs in most allogenic transplants. The disease occurs when donor marrow cells attack the recipient's tissues (5:896). With ALL transplant recipients, GvHD enhances survival by attacking malignant cells. The organs most vulnerable to GvHD are t
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Approximate Word count = 1842
Approximate Pages = 7 (250 words per page)

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