Alogenična transplantacija krvotvornih matičnih stanica u djece

master's thesis

• Title (english): Allogeneic haematopoietic stem cell transplantation in children
• Author: Monika Kale
• Mentor: Ljubica Rajić (mentor)
• Committee member: Ernest Bilić (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Ljubica Rajić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Transplantacija krvotvornih matičnih stanica koristi se kao rutinska procedura liječenja mnogih hematoloških i imunoloških bolesti te solidnih tumora u djece. Krvotvorne matične stanice su nezrele stanice, koje imaju mogućnost proliferacije i diferencijacije u sve vrste krvotvornih stanica. Izvori krvotvornih matičnih stanica su: koštana srž, periferna krv i umbilikalna krv. Alogenična transplantacija krvotvornih matičnih stanica (alogenična TKMS) je postupak u kojem pacijent prima krvotvorne matične stanice darivatelja. Primatelja je potrebno prethodno kondicionirati odnosno podvrgnuti kemoterapiji i/ili radioterapiji, kako bi se odstranile manje vrijedne hematopoetske stanice domaćina (tumorske ili genetski promijenjene), stvorio prostor za zdrave stanice iz presatka te onemogućio imunološki sustav domaćina u odbacivanju presatka. Darivatelj mora biti podudaran u sustavu antigena tkivne podudarnosti (HLA sustav). Pacijent može imati srodnog podudarnog darivatelja (brata ili sestru) ili nesrodnog podudarnog darivatelja u HLA sustavu. Nesrodni darivatelji nalaze se u dobrovoljnim registrima darivatelja krvotvornih matičnih stanica. Liječenje alogeničnom TKMS dijeli se u tri razdoblja: predtransplantacijsko razdoblje, transplantacija i posttransplantacijsko razdoblje. Komplikacije liječenja alogeničnom TKMS su u prvom redu infekcije, GvHD te rane i kasne toksične komplikacije kao posljedice provedenog kondicioniranja u predtransplantacijskom i imunosupresivne terapije u posttransplantacijskom razdoblju.
Cilj ovog rada je analizirati rezultate alogenične transplantacije KMS u djece liječene u Zavodu za dječju hematologiju i onkologiju Klinike za pedijatriju, Medicinskog fakulteta Sveučilišta u Zagrebu, KBC Zagreb. Retrospektivno su analizirani podaci 49 djece liječene alogeničnom TKMS u razdoblju od siječnja 2009. godine do prosinca 2014. godine. u Zavodu za dječju hematologiju i onkologiju Klinike za pedijatriju Medicinskog fakulteta Sveučilišta u Zagrebu i Kliničkog bolničkog centra Zagreb.

Abstract (english)

Hematopoietic stem cell transplantation is used as a common medical procedure for the treatment of numerous hematological, immunological illnesses and solid tumors in children. Hematopoietic stem cells are immature cells with the ability to proliferate and differentiate into all types of blood cells. The source of hematopoietic stem cells is the bone marrow, peripheral blood and the umbilical cord. Allogeneic hematopoietic stem cell transplantation (allo – HSCT) is a procedure in which the patient receives hematopoietic stem cells from a donor. Before the allo-HSCT patients must go through a conditioning treatment (chemotherapy and/or radiotherapy) to remove less valuable host hematopoietic cells (tumor or genetically changed cells), to create space for healthy cells from the transplant and to prevent the host's immune system from rejecting the transplant. The donor must be compatible in the histocompatibility antigens (HLA) system. The patient may have a sibling with a matching HLA system (related donor) or an unrelated donor with an identical HLA system. Unrelated donors can be found in the registry of voluntary hematopoietic stem cell donors. Treatment with allo-HSCT is divided into three phases: pretransplantation phase, transplantation and posttransplantation phase. Possible complications from allo-HSCT treatment are primarily infections, GvHD and early and late toxic complications due to the conditioning treatment in the pretransplantation and immunosuppressive treatment in the posttransplantation period. The aim of this study was to analyze the results of treatment with allogeneic HSCT at the Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine and University Hospital Center Zagreb. The data were retrospectively analyzed on the sample of 49 children which were treated with allogeneic HSCT in the period between January 2009 and December 2014 at the Division of the Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine and University Hospital Center Zagreb.

• Keywords: alogenična TKMS; djeca; kondicioniranje
• Keywords (english): allogeneic HSCT; children; conditioning
• Language: croatian
• URN:NBN: urn:nbn:hr:105:921431
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-16 09:30:40