EXPERIENCE OF THE NBTC IN THE PREPARATION OF AHSC GRAFT IN TUNISIA PREPARED BY: NADRA GABSI LEILA BEN HAMED F. JENHANI T. BEN OTHMEN S. HMIDA E. GOUIDER.

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Presentation transcript:

EXPERIENCE OF THE NBTC IN THE PREPARATION OF AHSC GRAFT IN TUNISIA PREPARED BY: NADRA GABSI LEILA BEN HAMED F. JENHANI T. BEN OTHMEN S. HMIDA E. GOUIDER M. MAAMER A. SKHIRI H. KAABI N. MOJAAT

Historical Overview 1958: Pr. Jean DAUSSET - discovery of the HLA system 1945: The bombings in Hiroshima and Nagasaki 1950’s Concept of "stem cell" - First clinical trials (failures) 1968: Robert A. Good -The first successful AHSCT … 1980’s: Widespread Clinical use of HSCs 1998: The first AHSCT in TUNISIA 2010 : AHSCT the only cure for many hematopoietic disorders

OBJECTIVE

We report data of the NBTC in the preparation of the graft using manual handling over 12 years

MATERIALS

Materials February 1998 – July patients total. Donors: HLA-identical siblings 53% Males 47% Females Median age: 21 years (Range: 2 – 62 years)

DISEASES 55% 45% ACUTE LEUKEMIA APLASTIC ANEMIA MALIGNANTNON MALIGNANT (41%) (28%) (11%)(17%)

SOURCES OF HSCs BONE MARROW PERIPHERAL BLOOD

METHODS

Major Minor Mixed ReceiverDonor GRAFT PREPARATION ABO- incompatibility

Blood cell depletion (Major or mixed ABO-incompatibility) Ficoll density gradient centrifugation

Manual blood cell depletion (Major and mixed ABO-incompatibility) Ficoll density gradient centrifugation

Manual blood cell depletion (Major and mixed ABO-incompatibility) Ficoll density gradient centrifugation

Plasma depletion (Minor ABO-incompatibility)

Graft quality LamellaMalassez cell FLOW CYTOMETRY The numeration of mononuclear cells (MNC) The count of CD34+ CFU-GM (Only in the first 7 years)

The most crucial step Samples of high quality Sufficient number of HSCs The PREPARATION of the GRAFT SO,

RESULTS

CELLS MNC ( x 10 8 /Kg) CD34+ ( x 10 6 /Kg) MeanMedian Extreme ≥ % – % 0.67 – 17

Correlation between MNC and CD34+ (Pearson statistical test ) P=0.000 Correlation coefficient=0.406

MinorCompatible Major & mixed 474 CASES TOTAL 3 groups

No immediate or delayed hemolysis No infectious events related to graft contamination

CONCLUSION

The manual handling of the graft slow and laborious procedure

conomic barriers afety of patients E S H ematological disorders

NCBMT Activity

Transition Manual handling Automatic preparation

THANKS

ransfusion enter lood ational NBTCTUNISIA

ransfusion enter lood ational N B T C TUNISIA

ransfusion enter lood ational NBTCTUNISIA

ransfusion enter lood ational N B T C TUNISIA

ransfusion enter lood ational NBTCTUNISIA

ransfusion enter lood ational N B T C TUNISIA