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a five paragraph essay 1 for both allogeneic and autologous transplants, hematopoietic cells are infused after the viagra online france administration of a combination of chemotherapy and/or radiation, termed the conditioning or preparative regimen. A myeloablative preparative regimen involves the administration of sublethal doses of chemotherapy to the recipient to eradicate residual malignant disease. The recipient will not regain his or her own hematopoiesis and will be at risk for substantial life-threatening nonhematologic toxicity. For those undergoing an autologous hsct, their hematopoietic cells must be harvested and stored before the myeloablative preparative regimen is administered. After the administration of the myeloablative preparative regimen, these hematopoietic cells serve as a rescue intervention to reestablish bone marrow function and avoid long-lasting, life-threatening bone marrow aplasia. In the setting of an allogeneic hsct, the preparative regimen is designed to suppress the recipient’s immunity, eradicate residual malignancy, or create space in the marrow compartment. Improved survival outcomes have been observed with both autologous and allogeneic hsct when the hematologic malignancy is in complete remission at the time of hsct. 2 at most hsct centers, age younger than 65 years and normal renal, hepatic, pulmonary, and cardiac function are considered eligibility requirements for myeloablative allogeneic hsct. The recognition of graft-versus-tumor effect, which likely is caused by cytotoxic t lymphocytes in the donor stem cells in those undergoing a allogeneic hsct transplant, led to investigations with nonmyeloablative transplants, in which less toxic preparative regimens are used in the hope of expanding the availability of hsct to recipients whose medical condition or age prohibits use of myeloablative regimens. A myeloablative or nonmyeloablative preparative regimen may be used for allogeneic hsct. Only myeloablative preparative regimens are used for autologous hsct. Histocompatibility histocompatibility differences between the donor and the recipient necessitate immunosuppression after an allogeneic hsct because considerable morbidity and mortality are associated with graft failure and gvhd. Rejection is least likely to occur with a syngeneic donor. In patients without a syngeneic donor, initial hla typing is conducted on family members because the likelihood of complete histocompatibility between unrelated individuals is remote. Siblings are the most likely individuals to be histocompatible within a family. The chance for complete histocompatibility occurring in an individual with only one sibling is 25%. Approximately 40% of patients with more than one sibling will have an hla-identical match.

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