1BIOLOGY Resetting of the Immune System after a Bone Marrow Transplant In order to replace the damaged bone marrow, either by any kind of disease or infection, a medical procedure is performed known as bone marrow transplant. The steps of this procedure includes the transplantation of the blood stem cells, which then generates new blood cells in the bone marrow inducing the new marrow’s growth (Townsley et al.). This results in the increased number of the white blood cells after 15 (approx.) days of the transplant. Although, sometimes the levels of T cells takes months to meet the healthy levels, as T cells are an important component of the immune system, thus longer the time taken for T cells production, the body is exposed to infections for longer time. In the entire response of the immune system against the harmful microorganisms and the pathogens, the T cells are solely responsible for the response (Noonan et al.). The response involves two kinds of T cells, helper T cells and cytotoxic T cells. The chemical signals generated after the microorganism invasion is sent to the cytotoxic T cells by the helper T cells. The cytotoxic T cells, then recognize and destroys the cells which are infected. The T cells are designed to recognize the different kinds of threats of the cells present in the thymus of the body, in which the elimination of T cells progenitors take place that reacts to the uninfected ornormal cells (Sbpdiscovery.org.). Thus different medications are provided to the patient in order to reset the immune system, so that the new cells being developed by the WBC are not destroyed by the immune system and thereby protecting the patient from getting exposed to severe infections (Schneeberger, Stefan, et al.). The primary source that will be used in this paper is a clinical study that is titled, “Psychosocial Predictors of Immune Response - Following Bone Marrow Transplantation”.It is formatted with an abstract, introduction, methods, results, data tables, discussion, and lastly a lengthy list of references. The introduction of the study provided a clear outline of the Bone
2BIOLOGY Marrow Transplant process, along with the dos and don’ts of the patients for effective treatment, the study has discussed about the risks of the infections due to weak immune system responses along with the other problems which are associated with the Bone Marrow Transplant. In the method section, Pulgar, et al. has provided a detailed data that were collected from the 31 patients of which 16 patients were males and 15 were females. The methods involves different sections like the description about the participants, the different psychological measures (the interpersonal behavior scale, Stressors and Coping Strategies for Cancer Inventory, The Hospital Anxiety and Depression Scale,Social Support Scale and life orientation test). The methodologies give a detailed clinical parameters of the transplant response, along with the procedure of the psychological assessment and its statistical analysis. The explicability of the presentation of the methods and study established the credibility of the study and maintained the integrity of the research data. In the result section, Pulgar et al. has provided few tables for the data collected. The first table depicts the measurement of the psychological variables along with the standard deviation scores. The statistics of clinical variables are shown in table two. Lastly, in table three the immunological response to BMT from the psychological variables is predicted by showing the stepwise regression analysis results. Pulgar et al. uses the discussion as an opportunity to summarize their findings as well as relate its relevates to the learning process and the admission of the fact that there may have been measurement errors when attempting to measure distributed practice. The secondary source is an article titled, “He Got Schizophrenia. He Got Cancer. And Then He Got Cured”; it was written byMoises Velasquez-Manoffand was published by the New York Times, on September 29, 2018. This article provided a general overview of the case study
3BIOLOGY of a man of age 23 diagnosed withparanoid schizophrenia, was getting treated by a psychiatrist Dr. Tsuyoshi Miyaokaatthe Shimane University School of Medicine in Japan (Nytimes.com). After a year the man was diagnosed withacute myeloid leukemiaand needed bone-marrow transplant for the treatment. In comparison to the primary source, the article is not broken down or formatted, it does not contain an abstract, data, results, research hypothesis, and/or discussion. The article does not contain any quantitative data that can be referenced to as concrete information to support the claims being made. However, there are references to other case studies but there is no established credibility considering the author of said article did not collect any data or participates in any research. The article provides a variety and multitude of information regarding the topic but fails to further explain the findings and the relevance of the data. The article generalizes the studies and do not provide the specific variables and traits that are tested and there are no diagrams or tables to display the organized data. There is also no list of references from other credible scientific journals, the only scientific information mentioned are cherry picked quotations and summarized accounts of previous clinical case studies. Unlike in the primary sources, the article tries to relate the research to the spike in shootings across the nation, rather than providing an objective, informative, and scientific perspective.
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4BIOLOGY References Noonan, Kimberly A., et al. "Adoptive transfer of activated marrow-infiltrating lymphocytes induces measurable antitumor immunity in the bone marrow in multiple myeloma."Science translational medicine7.288 (2015): 288ra78-288ra78. Nytimes.com.Opinion | He Got Schizophrenia. He Got Cancer. And Then He Got Cured.. [online]Availableat:https://www.nytimes.com/2018/09/29/opinion/sunday/schizophrenia- psychiatric-disorders-immune-system.html [Accessed 2 Aug. 2019]. Pulgar, Ángeles, et al. "Psychosocial predictors of immune response following bone marrow transplantation."Behavioral Medicine38.1 (2012): 12-18. Sbpdiscovery.org.Rebooting the immune system after a bone marrow transplant | SBP. [online] Available at: https://www.sbpdiscovery.org/news/beaker-blog/rebooting-immune-system-after-a- bone-marrow-transplant [Accessed 2 Aug. 2019]. Schneeberger, Stefan, et al. "Upper-extremity transplantation using a cell-based protocol to minimize immunosuppression."Annals of surgery257.2 (2013): 345. Townsley, Danielle M., Bogdan Dumitriu, and Neal S. Young. "Bone marrow failure and the telomeropathies."Blood124.18 (2014): 2775-2783.