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Bone Marrow

 

Overview

Inside your bones is a thick mass of cells called bone marrow. Every hour, a small number of stem cells in it create all other kinds of blood cells that exist in your body, including leukocytes, erythrocytes, and platelets. These cells are essential to your health - leukocytes fight infection, erythrocytes carry oxygen, and platelets help the blood clot.When a person has a blood disease, such as aplastic anemia or leukemia, doctors may perform bone marrow transplants to re-establish a healthy blood supply. Many transplants occur after a patient has received vchemotherapy or radiation treatment to destroy cancerous or other disease-causing cells. Both abnormal and normal cells are killed by these treatments, including stem cells. A bone marrow transplant starts the blood production process from scratch with normal stem cells. An allogeneic transplant - where another person's bone marrow is given to a patient - doesn't always work because of rejection or because of graft-versus-host disease. Rejection of the donor's marrow occurs because our bodies fight off invading foreign cells. If a donor's marrow doesn't match perfectly, the recipient's immune system may identify the new cells as foreign and destroy them, leaving the patient unable to create new blood. Graft-versus-host disease occurs because the new immune system from the donor's marrow may identify the patient's body as foreign and try to destroy it. When the donor's immune cells in the marrow attack the patient, many symptoms may result and, in severe cases, the patient could die.Doctors decrease these risks by trying to select a patient/donor pair whose immune cells will identify each other as "self." An identical twin's cells will see the other twin's cells as self. But most patients do not have an identical twin. So doctors look at a person's human leukocyte antigens (HLA) to match donor and patient bone marrow. These are proteins present on the surface of our cells. They play a big role in telling immune cells that other cells are either foreign or "friendly" self cells.Doctors will look at HLA antigens on your siblings' cells, because you have a 25 percent chance of having an HLA match with a brother or sister. Among unrelated people, only one in 20,000 people will be an acceptable match.

Activity

Find the connection between rolling dice and a genetic match. What are the chances of getting a match at random from an unrelated donor? In this activity, you will learn about probability using a pair of dice. Materials
  • pair of dice
  • paper
  • pencil
  • calculator
1. If you rolled a pair of dice, what chance would you have of getting matching numbers? Write down how many times you think you'd have to try before you got a match. 2. The first concept you need to know is that the probability of something happening is expressed in this simple equation: probability = number of favorable outcomes - divided - by - number of possible outcomes In this example, you're trying to get an outcome where the two dice match. A die is a cube with six possibilities: you can roll either a 1, 2, 3, 4, 5, or 6. So with one die, your probability of rolling a 5 is: 1 (number of favorable outcomes) - 6 (number of possible outcomes) 3. Next, you have to figure out how your probability changes when you roll a pair of dice. First, consider what the new number of possible outcomes is. Before, there were six. Now, there are many more combinations possible. Below is a chart listing all the possible rolls for your dice, naming them Die A and Die B. We started the chart to help you figure it out. Fill in the missing numbers to complete all the possible die rolls.
 Die A Die B   Die A Die B   Die A Die B   Die A Die B   Die A Die B   Die A Die B 1  &  1       1  &  2       1  &  3       1  &  4       1  &  5       1  &  6 2  &  1       2  &  2       2  &  3       2  &  4       2  &  5       2  & ( ) 3  &  1       3  &  2       3  & ( )      3  & ( )      3  & ( )     ( ) & ( ) 4  &  1      ( ) &  2       4  & ( )     ( ) & ( )     ( ) & ( )     ( ) & ( ) 5  &  1       5  & ( )     ( ) & ( )     ( ) & ( )     ( ) & ( )     ( ) & ( ) 6  &  1      ( ) & ( )     ( ) & ( )     ( ) & ( )     ( ) & ( )     ( ) & ( ) 
4. Count how many possible outcomes you can have when rolling two dice. If we wanted to calculate our chances of rolling a 5 on either or both dice, we would have to rewrite our probability equation: probability = ??? (Number of times Die A=5, Die B=5, or both=5 -- fill in your count from above) --- ??? (Number of all possible rolls -- fill in your count from above) 5. Now use what you've learned and the chart you've completed to calculate the chances of rolling matching die. Questions 1. The HLA proteins are determined by genes on chromosome 6. Each parent has two of these chromosomes, and these four HLA types are almost always different. You inherited one HLA type from each parent, as did your siblings. What is the probability that one of your siblings inherited the same HLA types that you did?

Resources

  • Altman, L.K. (1994, July 19) Baboon cells might repair AIDS-ravaged immune
    system. The New York Times, p. C3.
  • Brooks, A.C. (1994, Dec 10) Bone marrow
    transplants: Upping the odds. Science News, p. 391.
  • Coghlan, A. (1993, Apr 10)
    Blood cell 'factory' aims to end transfusions. New Scientist, p. 17.
  • Maugh,
    T.H. (1994, Dec 1) New tactic may ease transplants of bone marrow. Los Angeles
    Times, p. A1.
  • Stewart, S.K. (1994) Bone marrow transplants: A book of basics
    for patients (rev. ed.). Highland Park, IL: BMT Newsletter.
  • Wiegner, K. (1994,
    Dec 7) He's not my brother. Los Angeles Times, p. D10.
    Additional resource
    NEWTON'S APLE Show 1012 (blood typing). GPN: (800) 228-4630. Or call
    your local PBS station to find out when it will be rerun.
    Additional sources of information

    1. BMT Newsletter 1985 Spruce Ave. Highland Park, IL
      60035 (708) 831-1913
    2. National Marrow Donor Program 3433 Broadway St.
      NE, #400 Minneapolis, MN 55413 (800) 627-7692
      *