Hematopoietic Agents

Question 1

All hematopoietic cells develop from what type of cells?

Answer 1

Pluripotent hematopoietic stem cells in the bone marrow

Question 2

What is the deficiency state of platelets?

Answer 2

Thrombocytopenia

Question 3

What is the deficiency state of red blood cells (erythrocytes)?

Answer 3

Anemia

Question 4

What are the two groups of growth factors?

Answer 4

Multilineage and lineage-specific

Question 5

Difference between multilineage and lineage-specific growth factors

Answer 5

Multilineage- stimulate multiple lineages

Lineage-specific- stimulate differentiation of a single lineage

Question 6

What is the role of erythrocytes?

Answer 6

Transporting oxygen from the lungs to the tissues of the body

Question 7

True or false: Each hemoglobin molecule consists of two similar polypeptide chains, and each chain contains a binding site for molecular oxygen

Answer 7

False. Four similar polypeptide chains

Question 8

What is the major form of adult hemoglobin?

Answer 8

Hemoglobin A (2 alpha and 2 beta chains)

Question 9

True or false: Fetal hemoglobin (HbF) contains 2 alpha chains and 2 beta chains

Answer 9

False. 2 alpha chains and 2 gamma chains

Question 10

Which is more potent, HbA or HbF?

Answer 10

HbF has a higher affinity for oxygen to facilitate oxygen transfer from mother to fetus

Question 11

How is HbF converted to HbA?

Answer 11

After birth, DNA methylation inactivates the γ globin gene, and expression of the β globin gene rises

Question 12

How is HbS formed and what disorder is it responsible for?

Answer 12

Point mutation in the beta globin gene results in HbS, which is responsible for sickle cell anemia

Question 13

True or false: In β thalassemia, the β chain is structurally and functionally normal but under expressed

Answer 13

True

Question 14

Why does CKD inhibit erythropoiesis?

Answer 14

The kidney is the site of production of EPO, which stimulates the bone marrow to produce erythrocytes

Question 15

TPO is the precursor for what type of cells?

Answer 15

Platelets (thrombocytes)

Question 16

Where is TPO produced?

Answer 16

Mainly in the liver, but also in the proximal convoluted tubule of the kidney

Question 17

What are the 3 erythropoiesis stimulating agents used clinically in the U.S.?

Answer 17

.Recombinant human erythropoietin (rhEPO, aka epoetin alfa)
.Methoxy polyethylene glycol (PEG) (epoetin beta)
.Darbepoetin alfa

Question 18

MOA of Erythropoiesis Stimulating Agents

Answer 18

Stimulate erythropoietin receptor and induce erythropoiesis

Question 19

Agents that induce HbF

Answer 19

5-azacytidine and hydroxyurea

Question 20

MOA of hydroxyurea

Answer 20

Blocks cell division by inhibiting ribonucleotide reductase

Question 21

MOA of 5-azacytidine

Answer 21

Reverses methylation of the beta globin gene

Question 22

Agents that stimulate leukocyte production are used in the treatment of what?

Answer 22

Cancer and chemotherapy induced neutropenia

Question 23

Agents that stimulate leukocyte production

Answer 23

.Recombinant human G-CSF (filgrastim)
.Pegylated, long-acting form, PEG-G-CSF (PEG-filgrastim)
.Recombinant human GM-CSF (sargramostim).

Question 24

What is the main adverse effect of recombinant human G-CSF?

Answer 24

Bone pain, which resolves upon discontinuation of the drug

Question 25

Why should agents that stimulate platelet production be given prophylactically?

Answer 25

There is a 1-2 week delay before clinically significant results are observed

Question 26

Immunomodulatory Agents with Antineoplastic Applications

Answer 26

.Interferons
.Levamisole
.Interleukin-2
.Tretinoin

Question 27

What condition is characterized by below normal hematocrit or hemoglobin levels?

Answer 27

Anemia