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Hem/Oncology > Myelodysplastic Syndrome > Flashcards

Myelodysplastic Syndrome Flashcards

1
Q

what does the term senescence refer to?

A

with age hematopoietic stem cell (HSC) population has a reduced capacity for self-renewal

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2
Q

Hematopoietic stem cell (HSC):
Become more clonal in nature as one ages
and have a predisposition toward?

A

myeloid cells

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3
Q

risk factors associate with increased risk of MDS can referred to as Therapy-related myeloid neoplasms (TR-MN) which can be further divided into?

A

therapy-related MDS or AML

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4
Q

patients who receive intensive chemotherapy regimens have an _________ risk of TR-MNs

A

increased

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5
Q

the International Prognostic Scoring System (IPSS) classification and prognostic assessment includes what genes?

A

5q or 20q deletions and chromosome 7 abnormalities

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6
Q

what is recognized as a distinct subtype of MDS and has a favorable prognosis?

A

MDS with 5q deletions

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7
Q

MDS with 5q deletions have a high likelihood of response to what drug?

A

lenalidomide

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8
Q

for the classification and prognostic factors the multivariate analyses identified four prognostic factors which are?

A
  1. cytogenetic abnormalities
  2. percentage of bone marrow blasts
  3. age
  4. number of cytopenias
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9
Q

what are the labs associated with MDS?

A

anemia
neutropenia
thrombocytopenia
multiple cytopenias

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10
Q

what are the 3 goals of therapy for MDS?

A
  1. change natural history of the disease (e.g. delay disease progression)
  2. reduce number of red blood cell transfusions
  3. improve quality of life
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11
Q

what are the IMiDs used in lower-risk MDS?

A

thalidomide (limited b/c intolerable side effects)
linalidomide

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12
Q

IMiDs selectively suppress which del clones by inducing ubiquitination of haplodeficient casein kinase 1A1 (CK1α)?

A

del(5q)

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13
Q

what are the side effects/toxicities associated with thalidomide?

A
  1. fluid retention
  2. peripheral neuropathy
  3. thrombosis
  4. constipation
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14
Q

what level can determine if a patient is a candidate for erythropoiesis-stimulating agents (ESAs)?

A

EPO level

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15
Q

Patents with lower-risk MDS and symptomatic anemia who have a serum EPO level ____ mU/mL (U/L) can receive growth factor

A

≤500

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16
Q

what are the growth-colony stimulating factors (GCSF) used in lower-risk MDS?

A

filgrastim
luspatercept
eltrombopag

17
Q

which GCSF is a novel erythroid maturation drug?

A

luspatercept

18
Q

which GCSF is a novel drugs that stimulate the thrombopoietin receptor similar to endogenous thrombopoietin

A

eltrombopag

19
Q

what is the treatment goal of lower-risk MDS patients?

A

hematologic improvement

20
Q

immunosuppressive therapy is for what aged patients?

A

<60

21
Q

what are immunosuppressive agents that modulate effect T-cells?

A

antithymocyte globulin (ATG)
cyclosporine
corticosteroids

22
Q

what are the hypomethylating agents used in lower-risk MDS?

A

azacitidine
decitabine

23
Q

what are nucleoside analogs structurally similar to cytosine and capable of being incorporated into DNA instead of cytosine?

A

hypomethylating agents

24
Q

what are the side effects/toxicities associated with hypomethylating agents?

A
  1. myelosuppression
  2. febrile neutropenia
  3. n/v
25
Q

what is the treatment goal for higher-risk MDS?

A

change natural history of MDS

26
Q

what are the 3 treatment options for higher-risk MDS?

A

DNA hypomethylating agents
allogenic HSCT
IMiDs

27
Q

what are the hypomethylating agents used for higher-risk MDS?

A

azacitidine
decitabine with cedazuridine

28
Q

what is a inhibitor of cytidine deaminase that is used with decitabine to increase decitabine exposure with the oral route?

A

cedazuridine

29
Q

what is an oral B-cell lymphoma (BCL-2) inhibitor used with azacitadine?

A

venetoclax

30
Q

what is the intensive chemotherapy with AML-type induction combination chemotherapy regimen

A

anthracycline plus cytarabine

31
Q

is HSCT recommended for lower-risk MDS?

A

no

32
Q

MDS patients are at risk for?

A

anemia
infections

33
Q

if patients develop anemia they can have RBC transfusions this cant result in what complication?

A

iron overload

34
Q

MDS patients at risk for infections can receive what 2 drugs?

A

filgrastim and sargramostim

35
Q

Which of the following is true about complications of myelodysplastic syndrome (MDS)?
a) Patients with myelodysplastic syndrome (MDS) do not have risk of infections
b) Patients with myelodysplastic syndrome (MDS) can be treated with transfusions of red blood cells (RBC) for anemia but complications of transfusions include decrease in iron levels
c) Patients with myelodysplastic syndrome (MDS) can be treated with transfusions of red blood cells (RBC) for anemia but complications of transfusions include iron overload
d) Patients with myelodysplastic syndrome (MDS) do not have any complications due to the disease

A

C

36
Q

Patients with myelodysplastic syndrome (MDS) with 5q deletions generally have which of the following?
a) Favorable prognosis and are less likely to respond to lenalidomide
b) Poor prognosis and are less likely to respond to lenalidomide
c) Favorable prognosis and are highly likely to respond to lenalidomide
d) Favorable prognosis and are highly likely to respond to cisplatin

A

C

37
Q

Patients with myelodysplastic syndrome (MDS) can receive intensive chemotherapy as a bridge therapy to allogeneic hematopoietic stem cell transplantation (HCST) to?
a) Reduce tumor burden and control disease while suitable donor is found
b) Reduce tumor burden but not to control disease while suitable donor is found
c) Intensive chemotherapy is never given to patients with myelodysplastic syndrome (MDS)
d) Patients with myelodysplastic syndrome (MDS) can only receive targeted therapies for the treatment of the disease

A

A

Hem/Oncology (3 decks)

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