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HEM TEST 2024 > BMT facts > Flashcards

BMT facts Flashcards

1
Q

Timing of FLT3i/IDHi maintenance after allo transplant

A

+30
less evidence for IDHi

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2
Q

Duration of FLT3i maintenance after allo transplant

A

6-24 months
depending on tolerability

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3
Q

Tx of ICANS

A

for G>1
IV dexamthasone 10 mg q6h
if severe IV solumedrol + anakinra

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4
Q

tumor inflammation–associated neurotoxicity

A

pseudoprogression in the CNS after CAR-T. different entity than ICANS. focal inflammation at the tumor site not general like ICANS

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5
Q

Thiamine Tx after CAR-T

A

for severe CRS / ICANS

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6
Q

Rare neurologic complications after CAR-T

A

Myelitis
May be relate to PD1 Tx

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7
Q

Median time to ICANS

A

5-6 days

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8
Q

Movement and neurocognitive treatment–emergent adverse
events (MTNs) in relation to CAR-T

A

1-3 months after BCMA CAR-T
Parkinsonism
risk factors are CRS, ICANS and CAR-T persistence

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9
Q

Axi-cell costimulatory domian

A

CD28

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10
Q

DLI CR in AML

A

30-40%

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11
Q

DLI CR in ALL

A

15%

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12
Q

Acute and chronic GVHD rates after DLI

A

acute 12%
chronic 30%

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13
Q

Timing of prophylactic DLI

A

3-6 months after transplant

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14
Q

Strategies of DLI

A

Prophylactic- for HR pts
Preemptive- in MRD relapse or loss of donor chimerism

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15
Q

Dosing schedule of DLI

A

once a month for 4-12 months
until MRD negative

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16
Q

IVIG after CAR-T

A

IgG< 400
or rec. infections

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17
Q

Umbilical cord vs peripheral blood stem cells

A

Umbilical- less GVHD, longer engraftment
PB- higher GVL, higher GVHD, faster engraftment

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18
Q

MAC protocols

A

Cy120/TBI 12Gy
Cy120/Bu 16
F/ Bu 16

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19
Q

RIC agents

A

TLI
ATG

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20
Q

Buslfan SE

A

VOD
seizures

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21
Q

1s line Tx of chronic GVHD

A

steorids
CNI

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22
Q

2nd line Tx of chronic GVHD

A

Ibrutinib
Ruxo

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23
Q

2nd line Tx of chronic GVHD

A

Belumosidil
ROCK2 inhibitor

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24
Q

CMV prophylaxis post tranplant

A

Letermovir for CMV positive pts
With CMV negative donor

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25
Q

Important SE of CNI

A

TMA
PRES

26
Q

Anakinra in CRS/ICANS

A

effective in both
used for refractory symptoms

27
Q

2nd line Tx of acute GVHD

A

Ruxo

28
Q

Salvage as bridging to ASCT or sequential

A

ASAP trial
no advantage for salvage
Pts in ASCT arm got aggressive conditioning

29
Q

Risk factors for high grade CRS

A

LDH
Ferritin
CRP
PLT

30
Q

ICAHT

A

Immune effector cell associated hematoxicity
Long term cytopenias after CAR-T

31
Q

IEC-HC

A

HLH after CAR-T
treat with tocilizumab or roxulitinb

32
Q

Stem cell marker for collection before ASCT

A

CD34

33
Q

Preference of BM graft

A

In aplastic anemia

Less GVHD

34
Q

Preferred amount of CD34 cells for auto

A

Min 2 10^6
Preffered 4-5 10^6

35
Q

Preferred amount of CD34 for allo

A

5-6 10^6

36
Q

Prelixafor

A

Mosobil
CXC4
for poor mobilizers of stem cells for collection before auto/allo
If CD34 in PB less than 10 to microilter

37
Q

Drugs lowering the yield of Sc collection

A

Lenalidomide
Fludarabine

38
Q

DLI SE

A

GVHD
Aplaia

39
Q

ECP

A

Add psoralen
Irradiated of lympcytes
Sezary
Scleroderma
GVHD- less used now best of ruxo
May be effective as ECP ruxo combination for skin GVHD

40
Q

BCNU SE

A

Lung toxicity

41
Q

Relevant HLA in transplant

A

Class I- HLA A B C
Class II- HLA DR DQ

42
Q

F to M allo tranplant

A

More GVHD
Due to attack of Y chromosome

43
Q

Reactivation of CMV risk

A

CMV positive pts with CMV negative donors

44
Q

ABO mismatch in tranplant

A

Major- Ab in pts against donor antigen. Late engrafment. PRCA. Prevent with RBC depleted transplant.
Minor- ab in donor against pt antigen. Hemolysis. Prevent with plasma depletion.
Bidirectional- both. eg A and B

45
Q

Haplo vs MUD depending on conditioning

A

Haplo may be less effective in RIC
but controversial

46
Q

Haplo SE

A

CRS
Slower engraftment

47
Q

TBI risks/benefits

A

GVHD
Better in sanctuary sites (ALL)

48
Q

Bu/CY vs Bu/Flu

A

Bu flu less toxic
Less NRM

49
Q

Diseases with benefit of RIC

A

CML
CLL
FL
MCL

Due to high GVT in these diseases

50
Q

When to add ATG for GVHD p

A

MUD

51
Q

MSD MAC tranplant GVHD prophylaxis

A

CNI+MTX
Add ATG for MUD

52
Q

MSD RIC tranplnt GVHD prophylaxis

A

CNI+ MMF
Add ATG for MUD

53
Q

aGVHD G2 Tx

A

Solumderol
For at least 1 week
Then start slow tapering
Add budesonide for GI GVHD

54
Q

Screening for chronic GVHD

A

Genitalia
PFTs

55
Q

Tx of pulmonary chronic GVHD (BOS)

A

Fluticasone
Azenil
Monteleukast

56
Q

Dose of prednisone in GVHD

A

2 mg/kg in acute
1 mg/kg in chronic

57
Q

Belmusodil and axatilimab as 3rd line chronic GVHD

A

Effective in reducing fibrosis

58
Q

Axatilimab in CGVHD

A

anti-CSF1R
phase 2 study showing efficacy

59
Q

GVHD with PTCY

A

Less GVHD in haplo and also in matched donors related/unrelated

60
Q

Risk factors for prolonged cytopenias after CAR-T

A

CRS severity
Prior BMT
Pre CAR-T cytopenias

HEM TEST 2024 (32 decks)

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