Page 316 - Essential Haematology

302 / Chapter 23 Stem cell transplantation

Ciclosporin A therapy
Cyclophosphamide
50 mg/kg/day
Marrow infusion
Blood
transfusions
16
Haemoglobin (g/dL) 12
14

10

6 8
?Haemopoietic
growth factors
Platelet
transfusions
100
50 Total WBC
White cell/platelet counts (x 10 9 /L) 10 5 2 1 neutrophils
Platelets
20

Total

0.5
0.2
-4 -3 -2 -1 0 1 2 3 4 5 6 7
Time (weeks)

Figure 23.4 Typical haematological chart of a patient undergoing allogeneic marrow transplantation for aplastic

anaemia. WBC, white blood cells.

for 1 – 2 years. There is profound immunodefi ciency Autologous s tem c ell
for 3 – 12 months with a low level of CD4 helper t ransplantation
cells and a raised CD8 : CD4 ratio for 6 months

or more. Immune recovery is quicker after This allows the delivery of a high dose of chemo-
autologous and syngeneic SCT than following therapy, with or without radiotherapy, which oth-
allogeneic SCT. The patient s blood group changes erwise would result in prolonged bone marrow

’
to that of the donor and antigen - specifi c immunity aplasia. Stem cells are harvested and stored before
becomes that of the donor after approximately 60 the treatment is given and are then reinfused to
days. ‘ rescue ’ the patient from the myeloablative eff ects