Blood Stem Cell Transplant

Blood Stem Cell Transplant | You want to Know

Tissue engineering is a new breakthrough in medical field. Here, there are combination between biology science and engineering to create biological methode which can recover or replace the damage tissues. Bone marrow cells or peripheral blood cells have been cultured in laboratory, then the selected item from the culture will use to recover the damage tissues/organs.


Stem cells or progenitor cells are cells before differentiated with their ability to recover their damage continuously and unlimited by themselves. then, Stem cells differentiate into other cells. Stem cells can become neuron cells , heart cells, pancreatic cells, etc. Stem cell or progenitor cell has the potential to recover other damage tissue because of severe disease.


haemopoietic stem cell transplantation is blood stem cell or progenitor cell transplant procedure. Transplantation can between individuals or for himself.


Today, Blood stem cell transplant is usually used to :

• Recover bone marrow failure syndrome ( ex: leukemia, aplastic anemia, hereditery disorder, etc )
• Protect bone marrow from radiation or cytostatic chemotherapy with high dose (for example in Non Hodgkin limphoma )
• Enter the blood stem cell , gene therapy
  

Another Review about Cancer Symptoms

Leukemia

Chronic Limphocytic Leukemia (CLL)

Chronic Limphocytic Leukemia. (CLL)


Definition
Cronic Limphocytic Leukemia (CLL) is an malignancy of haematologic which is signed with Clonal ploriferation and accumulation of neoplastic limphocyte B in blood, bone marrow, limphonodes, splen, liver, & other organs. The symptoms can include lymphocytosis, limphadenophaty, and splenomegali. about 95% CLL is cell B neoplasm. and the others is cell T neoplasm.


Epidemiology
the average of patients's age when diagnosed are 65 years old, just 10-15% less then 50 years old. CLL increased risk occurs with age. relative risk ratio between old men and the old women are 2,8 : 1. the most patients are caucasian race and in middle income.
some patients with CLL have normal life, and the others die after 5 years later since diagnosed.


Cause
CLL cause still unknown. the possibilities are chromosome abnormalities, oncogen, & retrovirus (RNA tumour virus). about 50% CLL patients have sitogenic abnormalities, especially trisomy 12, chromosomal abnormalities 13 in line q14 (RB-1 suppressor gene location) , deletions of chromosomes 6 and 11. this is good detection in fluorescence in situ, hibridation than sitogenik conventional analysis.


Diagnosis
Clinical manifestation
in early diagnosis, most of CLL patients are asymptomatic. limphadenopathy generalisata, loss of weight and fatigue are the most found in patients with symptoms. Another symptoms include anorexia and decreased in exercise capacity. fever, sweat at night, and infection are rare in early stage and become worst in the next stage. Limphadenopathy, splenomegaly and hepatomegaly found in asymptomatic patients, when diagnosed because of cell B neoplastic accumulation.


Physical Examinations
lymphadenopathy is usually found in physical examinations. About 50% patients have lymphadenopathy and/or hepatosplenomegaly. with the progressiveness of CLL, the massive of limphadenopathy can cause obstructuve icterus, oudem in lower extremity, partial intestine obstructive. pleural effusion or acites related with bad prognosis.

Diagnostic Criteria

Patognomonic sign of CLL is increasing in the number of leukocytes with small lymphocytosis about 95%. Examination peripheral blood picture is needed to make good diagnosis. Infiltration lymphocytes in bone marrow (>30% lymphocytes).
CLL can be diagnosed if there is increase of absolute lymphocites in blood (>5.000/uL) and its morphology also immunophenotype showing specific picture.

Differensial Diagnosis

• Hairy cell leukemia
• Prolymphocytic Leukemia
• Mantle cell lymphoma
• Cell T cronic Leukemia
• LGL Leukemia
• mature cell T Leukemia
• etc

kind of Complications

1. Infection
2. Hypogamaglobulinemia
   found in more than 66% patients in the end of this disease.
3. It may transform into aggressive lymphoid malignancy
4. Secondary malignancy

Therapy
The Therapy for this desease may include..

• Chemotherapy

• Radiotherapy - Radiotherapy for This patients just palliative treatment. About 50-90% Patients show that the limpha become smaller size and reducing their pain after this treatment .
• Splenectomy - indication for Sympthomatic massive Splenomegaly, Sitopenia autoimune , and hiper splenism

The New treatment include

• Monoclonal Antibody

Source: for more informations see Buku Ajar Ilmu Penyakit Dalam Jilid II Edisi IV page 735-38 ( Text Book)




here, another Review about Cancer symptoms

Leukemia

Acute Limphoblastic Leukemia (ALL).

Acute Limphoblastic Leukemi (ALL).


Definition
Acute Limphoblastic Leukemia (ALL) is a clonal malignancy from precursor lifoid cells. About more than 80% cases, the dangerous cells come from limphocite B, and about 20% or less come from limphocite T. this type of leukemia attacks more in children. and about 20% this cancer cases attack in adult.


Etiology
the ALL cases is idiopatic in adult. the Genetic factor is more related in children's ALL cases. Environment also support occurance this disease. there are Ionic radiation, Chemotherapy drugs, , Epstein Barr Infection, high levels benzene exposure, smoke.


Clinical Presentation
there are many kind of clinical presentations.generally, there are the clinical symptoms related to the bone marrow failure. the Accumulation from Limphoblast cells malignant in bone marrow, cause the lack of blood normal cells in perifer. So, The clinical symptoms may related to anemia, infection, and Bleeding. but, the massive bleeding is rarely found.


the symptoms of ALL may found in clinical pictures can include :

1. Anemia, Fatigue, letargy, chest pain, dizziness, shortness
2. Anoreksia
3. pain in bone and joint ( because the infiltrating leukemia cells in bone marrow)
4. hipermetabolism symptoms ( fever and much sweting)
5. petechiiae, atraumattic ecchymosis, hematuria, GIT's bleeding
6. hepatomegaly
7. Splenomegaly
8. Limphadenophaty
9. Mass in mediastinum ( often in cell T ALL )
10. etc

Differential Diagnosis
-Anemia Aplastic
-Limphocytosis , Limphadenophaty, and Hepatosplenomegaly which relate to virus infection and limphoma


Laboratory pictures
generally, there are found Anemia and Trombocytopenia. about one-third patients have the trombotic count less than 25.000/mm3 .


Diagnosis Approach

• Anamnesis
• physical examination
• Laboratory examination
• thorax photo or Computed tomography
• Lumbal Pungsi
• Aspiration and bone marrow biopsy

Source: Buku Ajar Ilmu Penyakit Dalam Jilid II Edisi IV page 728-30 ( Text Book)




another review about Mesothelioma ( Pleural Cancer )