Chapter 21, Problem 3CCS

52-Year-Old Male with Multiple Sclerosis

Mr. Ayers was diagnosed with an aggressive form of multiple sclerosis 18 years ago. His illness has not responded to conventional treatments so he's been referred to your clinic for a clinical trial.

The doctor explains that his treatment will involve giving Mr. Ayers a drug that will release stem cells from his bone marrow so they can be collected from his blood. Then Mr. Ayers will be given (1) drugs that will destroy the blood-forming cells in his bone marrow, and (2), antibodies against his T lymphocytes. Finally, the stem cells that were collected from him will be used to repopulate his bone marrow.

The doctor says, “This treatment avoids problems, such as transplant rejection, that are associated with other kinds of transplants.”

3. NCLEX-STYLE The nurse explains to Mr. Ayers that a bone marrow transplant from another donor could result in the transplanted immune cells attacking his own cells. The best explanation for this

is:

a. Transplants from another person are never perfect matches. Any organ transplant could cause this problem.

b. A donor transplant would be a problem because Mr. Ayers's own immune system will be destroyed, so he wouldn't be able to fight off mismatched cells from a donor transplant.

c. Bone marrow is where immune cells are made. If Mr. Ayers received mismatched immune cells, these cells could attack his body.

d. Because Mr. Ayers has an autoimmune disorder, his body will attack anything transplanted into it.