Presentation of stem cell and bone marrow tranplan tation

1. MEDICAL SURGICAL NURSING STEM CELL AND BONE MARROW TRANSPLANTATION

2. SUBMITTED TO MR.P.YONATANSIR ASSOCIATE PROFESSER SUBMITTED BY MRS HEENA MEHTA S.Y.M.SC NURSING

3. LESSION PLAN Title of the course: S.Y. M.SC NURSING Topic: Stem cell and bone marrow transplantation Date-08-09-2012 Place: 3 RD YEAR B.SC NURSING CLASSROOM Class hours: 1 HOURS No of students: OF 3 RD YEAR B.SC.NURSING STUDENT Language: LACTURE BY ENGLISH Teaching Methods: LACTURE CUM DISCUSSION

4. Anatomy of cell

5. Function of human cell The cell is responsible for all of the functions of metabolism that support the body . . Blood cells transport oxygen, GLUCOSE, and other NUTRIENTS throughout the body and collect molecules of metabolic waste that cells in the liver and  KIDNEYS  dismantle, recycle, or eliminate from the body.

6. NERVE cells conduct electrical impulses.  MUSCLE  cells contract the  HEART  and move the body. Other cells make hormones, absorb nutrients, fight  INFECTION , and so on. Regardless of their specializations, however, the primary activity of all cells is the synthesis of the enzymes and proteins that carry out the biochemical tasks of living

7. what is stem cell Stem cells are  biological cells  found in all multicellular  organisms , It can  divide  (through  mitosis ) and  differentiate  into diverse specialized cell types and can self-renew to produce more stem cells.

8. In mammals, there are two broad types of stem cells:  embryonic stem cells , which are isolated from the  inner cell mass  of  blastocysts , and  adult stem cells , which are found in various tissues.

9. Embryonic stem cell Definition    Embryonic stem cells is the removal of cells from the blastocyte 4-5 days post fertilization for medical research.  

10. Adult stem cell Adult stem cells , like all stem cells, share at least two characteristics. First, they can make identical copies of themselves for long periods of time; this ability to proliferate is referred to as long-term self-renewal. Second, they can give rise to mature cell types that have characteristic morphologies (shapes) and specialized functions.

11. what is bone marrow transplantation Bone marrow transplantation (BMT), also called hematopoietic stem cell transplant or hematopoietic cell transplant, is a type of treatment for cancer.  

12. sources of bone marrow stem cell     Different source of bone marrow stem cell Peripheral blood stem cells ( PBSCs )- Bone Marrow Harvest Umbilical Cord Blood Stem cell

13. Peripheral blood stem cells ( PBSCs)- PBSCs are collected by an Aphresis . A process in which the donor is connected to a special cell separation machine via a needle inserted in the vein. Blood is taken from the vein and circulate though the machine which removes the stem cells and return s the remaining blood and plasma back to the donor though another needle inserted into the opposite arm.

14. Bone Marrow Harvest Bone marrowHarvesting involves collecting stem cell with a Needle placed into the soft cencer of the bone, the marrow. Mosst sites used for bone marrow harvesting are located in the hip and the sternum.

15. Umbilical Cord Blood Stem cell are filtered from blood in the umbelical cord after a baby is born    

16. Indication for bone marrow stem cell transplantation   multiple myeloma  or  leukemia   severe combined immunodeficiency  or  congenital neutropenia  with defective stem cells children or adults with aplastic anemia

17.   sickle-cell disease ,   myelodysplastic syndrome ,  neuroblastoma , lymphoma ,  Ewing's Sarcoma ,( malignant  small, round, blue cell tumour . It is a rare disease in which  cancer  cells are found in the  bone  or in soft  tissue )     chronic granulomatous disease  and  Hodgkin's disease .

18. types of bone marrow stem cell There are two main types of bone marrow transplantation: autologous and allogeneic

19. Autologous transplant  —  In autologous transplantation your own hematopoietic stem cells are removed before the high dose chemotherapy or radiation therapy. and are then frozen for storage and later use. After chemotherapy or radiation is complete, the harvested cells are thawed and returned to patient.

20. A llogeneic In allogeneic transplantation , the hematopoietic stem cells come from a donor, ideally a brother or sister with a similar genetic makeup. If you do not have a suitably matched sibling, an unrelated person with a similar genetic makeup may be used. Under some circumstances, a parent or child who is only half-matched can also be used;  

21. Myeloablative transplant  myeloablative transplant uses very high doses of chemotherapy or radiation prior to transplantation with autologous or allogeneic hematopoietic stem cells.

22. Non- myeloablative transplant A non- myeloablative transplant, sometimes referred to as a "mini" or reduced intensity transplant . Allows to have less intensive chemotherapy before transplantation with allogeneic hematopoietic stem cells. This approach may be recommended for a variety of reasons including age, type of disease, other medical issues, or prior therapies.

23. PRE-BONE MARROW TRANSPLANTATION PROCEDURES Bone marrow transplantation regimens vary from one patient to another, and depend upon the type of cancer, the treatment program used by the medical center, the clinical trial protocol (if the patient is enrolled in a clinical trial), as well as other factors.

24. BMT procedure The bone marrow harvest is the same for autologous and allogeneic transplants. Harvesting is done under general anesthesia . Bone marrow is drawn from the iliac crest with a special needle and a syringe.

25. Several punctures are usually necessary to collect the needed amount of bone marrow, approximately 1–2 quarts. (This amount is only a small percentage of the total bone marrow and is typically replaced within four weeks.) The donor remains at the hospital for 24–48 hours and can resume normal activities within a few days

26. If the bone marrow is meant for an autologous transplant. it is stored at -112–-320°F (-80–-196°C) until it is needed. If a patient's own bone marrow can be used for transplantation peripheral stem cells may be harvested from the patient's circulating blood.

27. The bone marrow or peripheral stem cells are administered to the recipient via a catheter inserted into a large vein in the chest. The donor cells look like a bag of blood and are infused for about 20–30 minutes . During the infusion, the patient's blood pressure, pulse, and breathing are monitored.

28. POST-BONE MARROW TRANSPLANTATION CARE A two- to four-week waiting period follows the marrow transplant before its success can begin to be judged. The marrow recipient is kept in isolation during this time to minimize potential infections. The recipient also receives intravenous antibiotic, antiviral, and antifungal medications, as well as blood and platelet transfusions to help fight off infection and prevent excessive bleeding. Blood tests are performed

29. daily to monitor the patient's kidney and liver function, as well as nutritional status. Other tests are performed as necessary. Further side effects, such as nausea and vomiting, can be treated with other medications.

30. side effect of the bone marrow stem cell transplantation The high-dose chemotherapy and total body irradiation required for bone marrow transplantation can have serious side effects

31.  Some of the most common side effects include: Mucositis  (mouth sores) and diarrhea Nausea and vomiting Loss of hair Infertility Organ toxicity Secondary cancers Graft versus host disease  Graft failure  Risk of death  

32. Summary Conclusion

33. Bibliography Javed Ansari, T/B of medical surgical nursing part- B,P.V.Book,page no-1211,1212. Web site www.cancer.org www.cell anatomy.com www.stemcell.com www.cancer treatment.org www.wikipedia.com

34. Assignment Write the role of nurse for bone marrow transplantation in pediatric

35. Thank you and have a nice day