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NK cells and KIR receptors: their importance in haematopoietic stem cell transplantations in leukemia
Ledvinková, Anna ; Vraná, Milena (advisor) ; Pačes, Jan (referee)
NK cells and KIR receptors: their importance in haematopoietic stem cell transplantations in leukemia Abstract This bachelor thesis discusses the importance of NK (natural-killer) cells in leukemias. It focuses on the structure and reactivity of NK cells, and especially on transmembrane KIR receptors (killer cell immunoglobulin-like receptors) of NK cells, that play an important role in the elimination of leukemic cells (graft-versus leukemia reaction, GvL) and thus in the overall prognosis of the disease. Activation and inhibitory receptors of KIR, by their cooperation, control the cytotoxic activity of NK cells. Thus, the typing of KIR receptor genes in hematopoietic stem cell donors can predict treatment success. KIR genes examination is mainly used in patients diagnosed with acute myeloid leukemia. Keywords: KIR receptor, NK cells, haematopoietic stem cell transplantation, HSCT, leukemia, donor, recipient
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Genotypic analysis of human cytomegalovirus in the patients after allogeneic haematopoietic stem cell transplatation.
Javornická, Tereza ; Hubáček, Petr (advisor) ; Španielová, Hana (referee)
In patients after allogeneic haematopoietic stem cell transplantation (HSCT) is a human cytomegalovirus (CMV) one of the most important viral pathogens. Its detailed characteristic could provide information about the impact of each CMV genotype on overall survival of the patient, and some serious complications, such as graft versus host disease (GvHD). This thesis deals with retrospective genetic analysis of samples from 1877 patients transplanted at the Clinic of Pediatric Hematology and Oncology, University Hospital Motol and the Institute of Hematology and Blood Transfusion since 2002. DNA from biological samples (especially whole blood) was isolated kit Qiagen DNA Blood Mini or Qiagen DNA Mini and samples were prospectively detected presence of CMV DNA. Samples were subsequently stored at -20 řC. Genotyping was performed using real-time PCR technologies to the genes of 2 structural proteins glycoprotein B, glycoprotein H and using sequence specific primers and probes. In 1343 samples (71.6%) from 390 patients there was only one strain of CMV; in 256 (13.6%) samples from 113 patients have detected mixed infection caused by two or more strains of CMV. The most common genotype demonstrated in "single" infection was in pediatric and adult patients gB1/gH2 detected in 118 (28.4%) patients. Most...
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ABO incompatibility in hematopoietic stem cell transplantation
PECHMANOVÁ, Alena
ABO incompatibility between the recipient and the donor is not a barrier for successful haematopoietic stem cell transplantation. Even though it is the HLA compatibility that has a major impact on engraftment, ABO incompatibility may cause a number of complications, e.g. both immediate and delayed haemolytic reaction, pure red cell aplasia and a higher level of GvHD. In my Bachelor's thesis, I investigated the influence of ABO incompatibility and the level of the initial titer of isoagglutinins on the red blood cell engraftment time, on the time of the complete transition to the donor erythropoiesis and on the number of transfused red blood cell products. I followed 104 patients who underwent haematopoietic stem cell transplantation. I divided the patients into four groups according to the ABO mismatch type (major, minor, bidirectional) or ABO match with the donor. In patients after transplantation, the blood group was repeatedly examined using the micro-column gel technique, which enables us to distinguish the dual population of donor and recipient derived erythrocytes, if they differ in the ABO or RhD antigens. The analysis revealed a statistically significant delayed red blood cell engraftment in patients with major mismatch caused by the destruction of newly forming precursors of the erythrocytes of the donor by anti-A, anti-B antibodies in the blood of the recipient. Neither prolongation of the time to complete transition to the erythropoiesis of the donor nor increased requirement of red blood cell products in this period of time were statistically significant in the case of major mismatch. There was no impact of the level of the initial titer of isoagglutinins on the monitored parameters in the examined patients. Foreign medical literature provides new findings based on which, after a consultation with physicians at the Transfusion Department, we agreed to change the ABO group of plasma products transfused to patients with minor and bidirectional mismatch after the transition to the erythropoiesis of the donor.
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