![]() ![]() The newer, or baby, stem cells can become any kind of cell, including T cells. They are restricted in their development and only become certain kinds of cells. The committed progenitor, or teenage, cells don’t cause GVHD, but they do take many months to mature, and there’s no guarantee they will grow into T cells. Mature T cells also may have a short lifespan and die off quickly, rendering them less effective. Therefore, sometimes doctors provide what is called a T-cell-depleted transplant to prevent GVHD. On the other hand, mature T cells in a graft can cause complications, such as graft versus host disease (GVHD), a condition in which the donor cells attack the recipient leading to organ damage and other life-threatening health problems. ![]() “The graft will have various levels of mature T cells, and the great advantage is that they can fight an infection soon after transplant,” said Weinberg. ![]() Mature, or adult, cells can be both helpful and harmful. While a bone marrow transplant may seem straightforward, a host of variables affect the success of the procedure.įirst, donor cells vary in their stage of development-some are newer (or baby) stem cells, some are committed progenitor (or teenage) cells, and others are mature (or adult) cells-and replenish the baby’s immune system in different ways. The higher the percentage of donor chimerism in a patient, the more donor cells the patient has, and the better the outcome for the patient, in general. One of the ways doctors determine whether the bone marrow transplant is working is by examining the chimerism, or percentage of donor versus recipient immune system cells, in a patient. In the case of SCID, the goal is for the healthy immune cells that the donor’s stem cells make to provide the recipient with a functioning immune system. After a successful BMT, the recipient has a mixture of their own cells and the donor cells, making them a chimera. These stem cells in the bone marrow, and the blood and immune system cells they make contain the donor’s DNA. When a baby with severe combined immunodeficiency (SCID)-or a different type of primary immunity such as Wiskott-Aldrich syndrome (WAS), for example-receives a bone marrow transplant (BMT), they become recipients of a donor’s blood-forming stem cells. ![]() The term ‘chimera’ refers to any organism with cells that do not all have the same DNA, in reference to the creature from Greek mythology that had a lion’s head, a goat’s body, and a serpent’s tail. “As a group, we need to do a better job at explaining what chimerism is,” said Weinberg. All three are members of CalSCID, a California-based program designed to examine and address the long-term follow-up care needs of families with SCID and T-cell lymphoma. Ken Weinberg from the Stanford University School of Medicine. Robertson Parkman from Children’s Hospital Los Angeles, and Dr. Mort Cowan from the University of California San Francisco, Dr. Ami Shah from the Stanford University School of Medicine, featured Dr. SCID Compass recently convened a panel of experts to discuss chimerism-an often daunting and confusing term-and how it plays a role in the recovery of babies with severe combined immunodeficiency (SCID) who receive bone marrow transplants (BMT). ![]()
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