HSCs

Question 1

Maximum volume marrow collection

Answer 1

20mL/kg

Question 2

Donor characteristic associated with enhanced survival

Answer 2

Age

Question 3

% decrease in survival for each HLA mismatch

Answer 3

5-10%

Question 4

Cell surface antigen used to identity HSCs

Answer 4

CD34

Question 5

Advantages of UCB

Answer 5

Less stringent HLA matching required

More rapidly available

Question 6

Factors affecting engraftment

Answer 6

HLA match
Dose
Source

Question 7

Rates of engraftment

Answer 7

Greatest with peripheral blood (14 day)
Marrow (21 days)
Then cord blood

Question 8

Minimum dose for marrow collection for efficient engraftment

Answer 8

2-3 x10^8 nucleated cells/kg

Question 9

Minimum dose for peripheral blood HSCs

Answer 9

2x10^6 CD34+ cells/kg

Question 10

Most common mobilization agent for PB Collection

Answer 10

G-CSF

Question 11

Cryoprotectant used most commonly for HSC storage

Answer 11

DMSO

Question 12

Storage temp

Answer 12

Generally

Question 13

UCB Collection consent and health history from:

Answer 13

Mother (father consent and history not necessary)

Question 14

History and donor testing for UCB required within:

Answer 14

7 days of collection

Question 15

Testing of UCB for hemoglobinopathies

Answer 15

Sickle or thalassemia trait may be banked

Homozygous abnormal or compound heterozygous abnormal are unsuitable for transplant

Question 16

In utero UCB collection

Answer 16

Performed by OB after delivery- no dedicated CBB collection personnel required
More training, education, and competency assessment needed

Question 17

Ex utero UCB collection

Answer 17

Performed by CBB staff
Allows for standardized methods and greater control
Allows for manipulation to increase collection volume
Lack of collectors may limit opportunities for collections

Question 18

HLA typing of UCB

Answer 18

Performed before cryopreservation

Must be verified after thaw using an integrally attached segment

Question 19

Transport considerations

Answer 19

Must be labeled ‘do not x-ray’

Question 20

UCB thaw solution

Answer 20

10% dextran with a protein source (usually albumin at 2.5-4.2%)

Question 21

Infusion of UCB

Answer 21

Infuse without delay after thaw/processing

Infuse by IV drip or push directly into central line (no needle or pump)

Vitals taken before, immediately after (infusion only 15-30 min) and 1 hr after

Question 22

Usual UCB volume

Answer 22

60-100 ml

Question 23

Additional infectious disease testing required

Answer 23

CMV

Question 24

G-CSF adverse symptoms in order of frequency

Answer 24

Bone pain
Myalgia
Head ache
Fatigue
Insomnia
Nausea
Flu like symptoms
Sweats
Loss of appetite

Question 25

engraftment delay after abo mismatch

Answer 25

Red cells delayed 40-60 days

Other cell lines unaffected

Question 26

Minor abo mismatch hemolysis

Answer 26

7-14 days post transplant

Passenger lymphocytes in the graft produce antibodies to patient RBCs

Question 27

HPC candidates with an HLA identical sibling

Answer 27

30-40%

=1-.75^n

Question 28

HPC-A complication

Answer 28

Hypokalemia

In part due to citrate metabolism
Low ionized calcium, low magnesium, prolonged QT intervals

Question 29

Marrow grafts regulated by

Answer 29

Public health services act

Question 30

Cellular therapies (P-HSCs and umbilical) regulated by

Answer 30

Title 21 CFR part 1271

Question 31

Products with positive infectious disease test

Answer 31

Labeled with biohazard

Stored in vapor phase nitrogen to minimize risk of contaminating other products