new_n_lost
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A six yr old male child has been on chemotherapy for Acute lyphoblastic leukemia.However,due to poor response,he is planned for bone marrow transplantation.Which of the following antigenic similarity is very mandatory?
a)Minor blood group factor
b)ABO antigen
c)MHC II
d)MHC I
e)collagen
Plz Explain ur Answers
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| jole
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B-blood group matching is the most important thing to do b4 a transplant.
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| new_n_lost
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| me007
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b - i guess it is very mandatory, why do you think it's not?
also
a - yes, bcs pt may be sensitized with blood transfusions or blood products
d - MHC-1 - it is HLA, better be compatible.
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| new_n_lost
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U r right Most initial compatiblity has to be of ABO antigen but in a bone marrow transplant u have to have MHC 1 compatibility as a must cos the initial Reaction by NK cells who can/will get into the Bone marrow will destroy any cell which has negative MHC 1 value n mount a Cytotoxic effect. Most of the Imp HLAs r HLA - A, HLA- B n HLA - DR as HLA- A n HLA -B r MHC 1 then we need to have a Atleast MHC 1 matching otherwise we will have a GVHD
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| doc179
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as far as I remember from Goljan patho book, it says particularly HLA-D loci should be matched, that means its MHC-II isn't it? then the answer should be C here, right?
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| new_n_lost
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well i had thought th esame for this question as choice C but in Bone Marrow transplant the situation gets a bit different i guess if u see the New Rapid Review i think in a table Goljan says that the Host acquires the Donor ABO grp table 3-3 Pg 48n on pg 46 he mentions that there shud be close matches for HLA-A,-B,-D among donors n recipients, that actually lead me to choose MHC 1 cos HLA-A ,-B r amongst MHC I.
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| doc179
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hmm...
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| indidoc1
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Hmmm... Both MHC-1&2 have to be tested bcoz we must match HLA A,B and DR-4. And if ABO matching is no done the patient's gonna hve a bad hemolytic anemia initially bcoz of pre-existing antibodies..
But the Q plays around wth words saying.. "Most mandatory"
Frankly speaking.. its a toss up
Will think abt this n post a final reply later..
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| epica
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Yes, I agree with Indidoc1.
I did some search, both are important but ans is MHC1 because of CD8 (cytot. cell)
From were this Q?
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| keepgoing
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yes agree MHC-I
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| lq2006
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MHC I
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| Addicudo
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I thought .. its MHC class II . didnt know the main facts .. but just that .. MHC II class def (Bare Lymphocyte Synd) deficiency causes NO GVHD .. Graft versus host disease .. therefore opted for it .. !! But .. guess the research .. from the net would be right .. !!! Good informative question though .. !
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| tompat
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ok,agreed MHC I
note that in class II deficiency there is no GVHD , from kaplan pg.347,
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