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Old 04-26-2014
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Embarrassed GVHD clarification please

Hello. i am studying about GVHD and a question came to my mind that wont let me pass this topic (as my usual obsessive way hahaha)

if we radiate and eliminate T CELLS from a bone marrow transplant wont that lead to elimination those T CELLS for ever???
so if patient needs t cell proliferation in the future he cannot ellicit a response from them because we wiped them out of the bone marrow?? so that person is completely empty of t cells??

please correct me if im wrong i dont know if im thinking too far beyond step1 hahaha otherwise please some clarify this for me, thanks
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Old 04-26-2014
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Yes that forms the basis of bone marrow transplants. The marrow is irradiated to eliminate all the malignant cells in the recipient and then the recipient is transplanted with HLA matched donor transplant, this now functions as source of stem cells for the donor. GMCSF is added to help in production of cells. However many a times some of the recipient cells will remain, hence GVHD occurs.

So many a time autologous bone marrow is used.i.e the persons bone marrow is stored, then irradiation/chemo is given to eradicate malignant stem cells and ultimately patient s own marrow is transplanted to eliminate pausibility of GVHD. This is what i have understood
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Old 04-26-2014
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@drpisho
GVHD will occur when the donor T cells attack the receptor body. When you perform a bone marrow transplant you do irradiate the receptor, but in most cases you don't irradiate the donors cells. So you still have T cells after the transplant. And most of these T cells clones are from the donor, not from the receptor.
In some occasions you do irradiate the donors cells, but usually it's when you really want to avoid the GVHD effect. But doing this you also lose the Graft versus tumor or leukemia effect. So usually for leukemias you don't irradiate.



@scores.
It's not the receptor t cells that produce GVHD, instead it's the donor T cells that "rejects" the receptor body. So it's like a rejection backwards.
Autologous BMT recipients usually does not develop GVHD. Because autologous T cells don't attack their own body. If you have GVHD after an autologous BMT you are facing a very rare complication and the pathophysiology is probably different from the classic GVHD.
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Quote:
Originally Posted by Corinthiano View Post
@drpisho
GVHD will occur when the donor T cells attack the receptor body. When you perform a bone marrow transplant you do irradiate the receptor, but in most cases you don't irradiate the donors cells. So you still have T cells after the transplant. And most of these T cells clones are from the donor, not from the receptor.
In some occasions you do irradiate the donors cells, but usually it's when you really want to avoid the GVHD effect. But doing this you also lose the Graft versus tumor or leukemia effect. So usually for leukemias you don't irradiate.



@scores.
It's not the receptor t cells that produce GVHD, instead it's the donor T cells that "rejects" the receptor body. So it's like a rejection backwards.
Autologous BMT recipients usually does not develop GVHD. Because autologous T cells don't attack their own body. If you have GVHD after an autologous BMT you are facing a very rare complication and the pathophysiology is probably different from the classic GVHD.
OH GOSH thanks!!!!!! makes perfect sense, i was generalizing that ALL bone marrow transplants are irradiated, now i know that they are ONLY irradiated when high risk of HLA incompatibility, thanks corinthiano
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