clinical: Stem cell transplantation

Question 1

Types of transplant

Answer 1

Syngeneic: from twins
Autologous: from patient
Allogeneic: from a match
Xenogeneic: from different species

Question 2

4 reasons for bone marrow transplant

Answer 2

Replace abnormal bt nonmalignant lymphohem system from a normal donor

Ablate to treat a malignancy

Immunotherapy

Gene Therapy

Question 3

Process for both Allogeneic and Autologous

Answer 3

Chemo-radio therapy
Pancytopenic Stage
Engraftment

Question 4

Difference in preservation between autologous and allogeneic

Answer 4

Autologous is cryopreserved whereas Allogeneic is preferred fresh not frozen

Question 5

Drug used for conditioning to eradicate hyperplastic host hematopoesis

Answer 5

Cyclophosphamide

Question 6

Indications from Stem cell transplant

Answer 6

Non-hodgkins lymphoma included relapsed diffuse large b cell lymphoma

Multiple myeloma (FIRST LINE AND IMPROVES SURVIVAL)

Question 7

Allogeneic stem cell transplant indications

Answer 7

Intermediate or High risk AML

Ph+ ALL in adults less than 60

CML (not first line)

Refractory Non-hodgkins leukemia

Aplastic Anemia: for less than 20 yo, sibling match 20-40

Non-malignant Disease: thalassemias and sickle cell

Severe Myeloproliferative Disorders: younger and with match

Myeloproliferative Syndrome advanced disease w/ matched donor and transplant eligible

Question 8

What Non malignant disease can be treated with allogeneic stem cells

Answer 8

Thalassemias and Sickle Cell

Question 9

Low grade lymphomas

Answer 9

Follicular Lymphoma

CLL/SLL

Question 10

Aggressive Lymphomas

Answer 10

Diffuse large b cell lymphoma

Mantle Cell Lymphoma

Question 11

Highly aggressive Lymphoma

Answer 11

Burkitt’s Lymphoma

Lymphoblastic Lymphoma

Question 12

Acute Myeloid Leukemia good Cytogenetics

Answer 12

t(15;17)
t(8;21)
Inversion 16
FLT3-; NPM1+

FLT3-;NPM1-; CEPBA double mutant

Question 13

Acute Myeloid Leukemia Intermeduate Cytogenetics

Answer 13

Normal
Trisomy 8
Trisomy 21

Question 14

High risk Cytogenetics for Acute Myeloid Leukemia

Answer 14

-5, -7, 11q23

FLT3+

Complex

Secondary AML or t-AML, MDS-AML

Question 15

Philadelphia + ALL is a definitive indication for

Answer 15

stem cell transplant in CR1

Question 16

Some viral complications for Stem cell transplants

Answer 16

CMV
Adeno virus w/ EBV
(presents w jaundice, elevated AST and ALT and viral PCR+)

Question 17

Acute graft versus host disease can present w/ what sort of rash and where?

Answer 17

Maculopapular Rash on the trunk, neck and palms, also presents w/ diarrhea

Question 18

Most common cause of mortality after transplantaion

Answer 18

Infection

Question 19

Common fungal infections in bone marrow stem cell transplant patients

Answer 19

Candida
Aspergillus
Mucor