[醫如往常] Senior Clerkship Day 99: Lab Medicine: 細胞保存

細胞保存

陳教授

第一例骨髓移植在1958 Yugoslavia

Aplastic anemia

MUD

最後長出自己的骨髓

http://www.signalsblog.ca/the-story-of-the-first-bone-marrow-transplant/

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1966 HLA

1968 SCID 做BMT

Dr. Robert Goods

ED Thomas 1990 Nobel Prize

MTX for GVHD

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冷凍骨髓CD34

• Viability
• DMSO
• 減少RBC, WBC數量

陳教授去MD Anderson 學冷凍

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Adhesion marker:40, 41, 44

Bone marrow

• CD34
• MSC; mesenchyme stem cells
• fibroblast

收集到的cell<20%是lymphocyte (mainly B cell)

PBSC

收集到的cell>30%是lymphocyte (mainly T cell)

容易GVHD

1986 cord

用一次三十萬台幣

日本15萬日幣

日本50% BMT 用cord blood, 而且只用1U

其他國家大都用2U

姚明1993做台灣第一例MUD cord blood

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Baby bank私庫很不好，用到的機率1/20000

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Acute leukenia不用做bone marrow biopsy

除非是hairy cell, ALL 太黏抽不出來才做biopsy

其他像是myelofibrosis, CML, aplastic anemia一定要做biopsy

CML的staging一定要做biopsy

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