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Old 05-09-2011
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Immunology Graft versus Host Disease Question

In organ transplantation, graft vs. host disease may be induced by donor T lymphocytes. Which of the following disease-specific organ transplant is most likely to derive some benefit from this graft vs. host response?

a. Bone marrow transplant for AML
b. Heart transplant for viral cardiomyopathy
c. Islet cell transplant for type 1 DM
d. Kidney transplant for membranous glomerulonephritis
e. Lung transplant for primary pulmonary hypertension

Can someone please explain this to me?

Thanks!
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Old 05-09-2011
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This question is just asking for the role of T cells in each of those cases. If I had to go with one, I would go with A).

Just a guess though..
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Old 05-09-2011
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bone marrow transplant for AML. or lung transplant for pulmonary hypertension.....

Last edited by drmdshah; 05-09-2011 at 08:44 AM.
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Old 05-09-2011
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This question is very poorly written, where did you get it from?

GVHD occurs only in immunogenic organ transplant, therefore only option A can be correct, all other opitons are for organs that are not capable of producing T cells.

But again this question is incorrect and is not USMLE style at all
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Old 05-09-2011
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hi..FA 2011 page 215...graft vs host ds..potentially beneficial in bone marrow transplant....hope this helps u..
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Old 05-09-2011
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Quote:
Originally Posted by Mahir View Post
This question is very poorly written, where did you get it from?

GVHD occurs only in immunogenic organ transplant, therefore only option A can be correct, all other opitons are for organs that are not capable of producing T cells.

But again this question is incorrect and is not USMLE style at all
Or maybe this is one of those straightforward, is-this-even-USMLE type of questions?
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Thanks for all the answers... I took nbme 5 yesterday online and am reviewing the offline version today. I also picked A but the answer key I have says it's the Lung transplant. I'm using FA 2010 and it wasn't in there, so thanks to drmdshah for the reference.

Thanks!
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Old 05-09-2011
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Hi,

I have taken a year out to study immunology...from what I've learnt, I would go with option (A)

Rationale:

In AML, transformed ''self'' leukocytes undergo uncontrolled clonal proliferation to the detriment of other cell lines i.e. they become cancerous.

Prior to a bone marrow transplant (BMT), the patient would usually undergo either myeloablative chemotherapy or non-myeloablative chemo to destroy existing cell lines (including bone marrow haematopoietic stem cells), so as to ''create'' space for incoming graft stem cells.

Once graft stem cells are infused and ''colonise'' their mesenchymal niche, they proliferate.

Graft white cells would recognise any remaining self leukaemic cells as foreign, hence as it were - get rid of the cancer.

To summarise, graft vs host is useful especially in haematological malignancies where you would want transplanted cells to kill malignant self cells.

Hope this helps

x
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Quote:
Originally Posted by Dr_Laura View Post
Thanks for all the answers... I took nbme 5 yesterday online and am reviewing the offline version today. I also picked A but the answer key I have says it's the Lung transplant. I'm using FA 2010 and it wasn't in there, so thanks to drmdshah for the reference.

Thanks!
I don't understand how GVHD would be beneficial in lung transplant. I picked AML too. please explain if you got it.
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Quote:
Originally Posted by Dr_Laura View Post
Thanks for all the answers... I took nbme 5 yesterday online and am reviewing the offline version today. I also picked A but the answer key I have says it's the Lung transplant. I'm using FA 2010 and it wasn't in there, so thanks to drmdshah for the reference.

Thanks!
you always welocme..best luck for futher study..
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Old 05-21-2011
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Correct answer is A
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Old 05-17-2015
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PAGE 214, FA 2014

CORRECT ANSWER IS AAAAAAAA!
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Old 05-18-2015
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Correct answer is A. With bone marrow transplant, GVHD will kill all the cancer cells that may still be present.
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Old 05-19-2015
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In a nutshell .[in graft versus host donor cytotoxic T cell attack the host cells.because donor cytotoxic t cell recognize host tissue as foreign. as we know bone marrow is rich in lymphocyte so chances of graft versus host disease more commonly devlop in bone marrow transplant than anyother transplant. donor bone marrow lymphocyte attack host cell. second most commonly occur in liver transplant as liver is also lymphocyte rich]
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Old 07-25-2015
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Correct Answer I Agree with you!

[QUOTE=virendra ravat;757753]In a nutshell .[in graft versus host donor cytotoxic T cell attack the host cells.because donor cytotoxic t cell recognize host tissue as foreign. as we know bone marrow is rich in lymphocyte so chances of graft versus host disease more commonly devlop in bone marrow transplant than anyother transplant. donor bone marrow lymphocyte attack host cell. second most commonly occur in liver transplant as liver is also lymphocyte rich][/QUO
I think the way to answer these types of questions are eliminating the impossible answers. Graft-versus-host occurs only in limited transplataion like bome marrow or liver (spleen possibly?!)
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