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EXPERIENCE OF THE NBTC IN THE PREPARATION OF AHSC GRAFT IN TUNISIA

EXPERIENCE OF THE NBTC IN THE PREPARATION OF AHSC GRAFT IN TUNISIA. PREPARED BY: NADRA GABSI LEILA BEN HAMED. M. MAAMER A. SKHIRI H. KAABI N. MOJAAT. F. JENHANI T. BEN OTHMEN S. HMIDA E. GOUIDER. Historical Overview. 1945: The bombings in Hiroshima and Nagasaki

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EXPERIENCE OF THE NBTC IN THE PREPARATION OF AHSC GRAFT IN TUNISIA

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

  2. Historical Overview • 1945:The bombings in Hiroshima and Nagasaki • 1950’sConcept of "stem cell" - First clinical trials (failures) • 1958:Pr. Jean DAUSSET - discovery of the HLA system • 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 2010

  3. OBJECTIVE

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

  5. MATERIALS

  6. Materials February 1998 – July 2010 • 474 patients total. • Donors: HLA-identical siblings 53% Males 47% Females Median age:21years (Range: 2 – 62 years)

  7. DISEASES 55% 45% ACUTE LEUKEMIA APLASTIC ANEMIA (41%) (28%) (11%) (17%) MALIGNANT NON MALIGNANT

  8. SOURCES OF HSCs BONE MARROW PERIPHERAL BLOOD

  9. METHODS

  10. GRAFT PREPARATION ABO-incompatibility Donor Receiver Major Minor Mixed

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

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

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

  14. Plasma depletion(Minor ABO-incompatibility)

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

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

  17. RESULTS

  18. Mean Median Extreme ≥2 MNC ( x 108/Kg) 3.06 2.6 0.67 – 17 76% 3.03 CD34+ ( x 106/Kg) 71% 3.83 0.23 – 21.83

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

  20. 474 CASES TOTAL 3 groups Major & mixed Minor Compatible

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

  22. CONCLUSION

  23. The manual handling of the graft slow and laborious procedure

  24. E conomic barriers S afety ofpatients H ematological disorders

  25. NCBMTActivity

  26. Automatic preparation Transition Manual handling 1998-2010

  27. THANKS

  28. ational lood ransfusion enter TUNISIA N B T C

  29. N ational B T lood ransfusion C enter TUNISIA

  30. ational lood ransfusion enter TUNISIA N B T C

  31. N ational B T lood ransfusion C enter TUNISIA

  32. ational lood ransfusion enter TUNISIA N B T C

  33. N ational B T lood ransfusion C enter TUNISIA

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