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Edheads Stem Cell Transplant: Teacher's Guide

Recommended Grade Levels: 10 - 12 and up

Table of Contents:

  1. Assessment and discussion
  2. Ohio State Standards
  3. National Science Standards

Tips for using the site with students      

  1. Before using this activity in class (or at home), go through the activity once to make sure it works correctly on your computer(s).  If the activity does not load after clicking the 'start' button, you may be asked to download the free Flash Player from Adobe.com. Please click yes, as this allows you to view the Edheads Stem Cell Transplant activity.  If you are using school computers, you might need to contact your tech support team to download the Flash Player.

  2. Your computer(s) will need to have some sort of sound output. Either speakers or headphones will work well. The majority of this activity has voice audio. We highly recommend headphones or ear buds in a classroom setting. Students with hearing impairments can read the text at the bottom of the screen.   If you are having difficulty hearing, check the audio settings on your computer.  

  3. We strongly recommend that students use a real mouse, as the touch pads on laptop computers are more difficult to use for this activity and slow students down significantly. 

  4. If the teacher would like students to fill out a worksheet while doing the activity, that can be printed here (PROVIDE LINK TO WORKSHEET).  The worksheet is NOT necessary to complete the activity, but is a way for students to show they have done the activity or for teachers to track student progress.

  5. Students in the target grade-range will take approximately 25-30 minutes to complete the entire activity. 

  6. This activity is one of three available on the Edheads web site on stem cells. The first activity, Create a Stem Cell Line, is an introduction to stem cells, what they can do, and the vocabulary used by stem cell biologists.  This activity, Stem Cell Transplant, provides a current application of stem cells and introduces a new line of real, ongoing research using stem cells called MAPCs.  The third activity, Stem Cell Heart Repair, coming in March 2011, introduces two lines of new research to determine how best to use stem cells to repair the heart.  These research projects are currently in clinical trials to be approved by the FDA.  The three stem cell activities can be used together, individually or in combination as the teacher sees fit.  If all three activities are done together, they are intended to provide an in-depth overview of what stem cells are, and how they might be used in human medicine now and in the future.

Worksheet 

The worksheet for this activity is optional.  Teachers may choose to have their students do the worksheet as a means of ascertaining that the students have completed the activity.  However, the worksheet is NOT required to complete the activity. 

Answers to the Worksheet 

  1. What does AML stand for?  Acute Myeloid Leukemia.
  2. What characteristic seen in myeoblast cells indicates AML?  Auer rods.

If you chose Wendy as the patient:

  1. What is the first step to becoming a bone marrow donor?  Cheek swab.
  2. What is HLA?  Human Leukocyte Antigens, which are proteins found on the outside of the cell.
  3. How many HLA antigens must be the same for a bone marrow donor match?  5 of 6.
  4. Why are neutrophils, a type of white blood cell, counted?  To determine if the transplanted cells are growing in the bone marrow and to ensure that the immune system is becoming functional again.
  5. What is graft versus host disease?  When the T-cells of the transplanted immune system attack the cells of the host’s body.
  6. What are the potential risks of the experimental stem cell therapy that Wendy participates in?  It might not work, it could cause a reaction similar to an allergic one, or tumors could grow.

If you chose Michael as the patient:

  1. Why is it hard to find a match for Michael in the bone marrow registry?  His race.  The bone marrow registries are predominantly filled with Caucasian donors, making it harder for an African American to find a match.
  2. How many HLA antigens must be the same for an umbilical cord donor to match? 4 of 6.
  3. What are the risks associated with a stem cell transplant? Risks include rejecting the graft developing graft versus host disease, reacting unfavorably to the high doses of chemotherapy before the transplant, or lacking an immune system for awhile. 
  4. What is the conditioning step of the transplant supposed to accomplish?  To rid the body of the leukemic cells and the patient’s immune system, and make room in the bone marrow for the new stem cells that will be added.
  5. What does a patient’s neutrophil count need to be in order to be released from the hospital?  500 cells per microliter or higher for three days consecutively.
  6. Why does a stem cell transplant start with counseling?  Because it is a grueling treatment with a long hospital stay and there are numerous risks involved.

Assessment and discussion 

For an assessment tool, teachers may want to have students put their names on the Worksheets and turn them in.  These should indicate if students completed the assigned activity.

A quick 20 question quiz can be found here.

Answers to the quiz questions can be found here.

After students use the site, additional in class discussion questions (which can also act as assessment tools) can be asked:

  • Have students heard of cord blood banks?  What do they know about these?  There are both public and private banks.  What are the differences between the two?  Answer:  Publicly supported cord blood banks act much as public blood banks do – they accept donations and hold them for anyone who needs them and are supported by public funds.  Private banks require that individuals pay for the maintenance of the cord blood for as long as it is held.  The private banks also only give the donations back to the donor – donations are not available to anyone who might be sick and in need.  In many instances, private banks use ethically questionable methods to solicit cord blood donations from anxious parents and incorrect information is given.  If a child were to develop leukemia, their own cord blood could not be used to give them a stem cell transplant, as the leukemic cells would just be reintroduced to the child.  Other cord blood from another donor would have to be used.  Also, cord blood cannot be stored forever and remain viable, but many of these private banks continue to charge parents to maintain the cord blood even after it is no longer of any use to anyone.  This is a case of science getting ahead of the legal system.  Can students think of any other case where that might have occurred?  (One example: heroic measures of maintaining life were available before living wills were, so the patient that might not want that had no way to say so before being put on life support).
  • What is chemotherapy, what is radiation and when are they used for cancer patients?  This question is very involved and might be assigned as a home work project or given to groups of students to research and answer.  Basically, chemotherapy is a drug or series of drugs that are given to kill cancer cells.  The problem is that these drugs often have severe side effects because they are killing healthy cells too, like hair follicles, or cells in the gastrointestinal tract.  This results in hair loss, nausea, vomiting and diarrhea.  Radiation is used most often in localized areas to kill cancer cells in a tumor or to kill remaining cells after a tumor is removed.  This also has side effects like pain in the area irradiated or ‘burns’ from the radiation.  The choice of which treatment to use is based on the type of cancer, its location and a number of other factors that doctors consider before prescribing treatment for their patients.
  • Why is there more likely to be a bone marrow donor match if you are Caucasian? Why is the likelihood of finding a matching donor so low for people of mixed race?  Those individuals with ancestors of a single race are more likely to be matched than those with diverse ancestors.  Those needing a bone marrow transplant in Japan are very likely to find a donor because the population of Japan is very homogenous, increasing the odds that a match will be found.  That is NOT true in the United States.  In the US, there is a ‘melting pot’ of races and many individuals with a wide variety of ancestral races exist and intermingle, producing more children with an even higher diversity of ancestral races.  If students are interested in this topic, the teacher might suggest having students write down the races and countries of origin for their parents, grandparents and, if information is available, great grandparents.  See if students can find a matching set of ancestral races within a class or a set of classes.        
  • How do you become a bone marrow donor?  Full information on this topic is available at: http://www.marrow.org/.  For most people, they would start the process with a cheek swab.  Teachers might suggest students become part of the bone marrow donor database, especially if they are of mixed race.  They could help save a life.

Ohio State Standards – Benchmarks and Indicators     

Science & Technology

Grade 10:

Life Sciences

Historical Perspectives and Scientific Revolutions

  1. Describe advances in life sciences that have important long-lasting effects on science and society (e.g., biological evolution, germ theory, biotechnology and discovering germs).

  2. Analyze and investigate emerging scientific issues (e.g., genetically modified food, stem cell research, genetic research and cloning).

Science and Technology

Understanding Technology

  1. Cite examples of ways that scientific inquiry is driven by the desire to understand the natural world and how technology is driven by the need to meet human needs and solve human problems.

  2. Describe examples of scientific advances and emerging technologies and how they may impact society.

Scientific Inquiry

Doing Scientific Inquiry

  1. Research and apply appropriate safety precautions when designing and conducting scientific investigations (e.g. OSHA, MSDS, eyewash, goggles and ventilation).
  2. Present scientific findings using clear language, accurate data, appropriate graphs, tables, maps and available technology.
  1. Draw conclusions from inquiries based on scientific knowledge and principles, the use of logic and evidence (data) from investigations.

Scientific Ways of Knowing

Science and Society

  1. Investigate how the knowledge, skills and interests learned in science classes apply to the careers students plan to pursue.

Life Science

Grade 11:

Characteristics and Structure of Life

  1. Describe how the maintenance of a relatively stable internal environment is required for the continuation of life, and explain how stability is challenged by changing physical, chemical and environmental conditions as well as the presence of pathogens.

Scientific Inquiry

Doing Scientific Inquiry

  1. Evaluate assumptions that have been used in reaching scientific conclusions.

  2. Design and carry out scientific inquiry (investigation), communicate and critique results through peer review.
  1. Summarize data and construct a reasonable argument based on those data and other known information.

Scientific Ways of Knowing

Science and Society

  1. Explain that the decision to develop a new technology is influenced by societal opinions and demands and by cost benefit considerations.
  1. Research the role of science and technology in careers that students plan to pursue.

National Science Standards for Grades 10-12     

Science as Inquiry:

  • Abilities necessary to do scientific inquiry
  • Understandings about scientific inquiry

Life Science:

  • The cell

Science and Technology

  • Understandings about science and technology

Science in Personal and Social Perspectives:

  • Science and technology in local, national, and global challenges

History and Nature of Science:

  • Science as a human endeavor
  • Nature of scientific knowledge


 
   

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