Myelodysplastic syndrome and stem cell transplant

Question 1

What are the characteristics of myelodysplastic syndrome?

Answer 1

(1) Hypercellular bone marrow
(2) Peripheral blood cytopenias
(3) Ineffective hematopoiesis
(4) Potential to progress to acute leukemia

Question 2

What is characteristic of blood smears in myelodysplastic syndrome?
(4)

Answer 2

(1) Multinuclear RBC precursors at various stages of maturation, indicating asynchronous maturation
(2) Hypolobulated neutrophils (Pseudo-Pelger-Heut cell)
(3) Micromegakaryocytes
(4) Ringed sideroblasts

Question 3

How is myeloplastic syndrome treated?

Answer 3

(1) Transfusions, hematopoietic growth factor
(2) Chemotherapy
(3) Allogeneic stem cell transplant is the only possible cure

Question 4

What are the two types of sources of stem cells?

Answer 4

(1) Autologous - patient’s own stem cells

(2) Allogeneic - another person’s stem cells

Question 5

What is the technique for collecting stem cells?

Answer 5

Apheresis (for peripheral blood stem cells)

Question 6

Which diseases are treated with autologous stem cell transplants?

Answer 6

(1) Multiple myeloma
(2) Hodgkin’s lymphoma
(3) Amyloidosis
(4) Solid tumors - neuroblastoma, germ cell tumors, ovarian cancers

Question 7

Which diseases are treated with allogeneic stem cell transplants?

Answer 7

(1) Acute leukemia
(2) Myelodysplastic syndrome, myeloproliferative disorders
(3) Non-Hodgkin’s lymphomas
(4) Aplastic anemia, paroxysmal nocturnal hemoglobinuria
(5) Thalassemia

Question 8

What mediates graft vs host disease?

Answer 8

(1) Graft T cells recognize host cells as foreign

(2) Acute form results from cytokines, leading to skin rash

Question 9

How is graft vs host disease prevented?

Answer 9

Immunosuppression: calcineurin inhibitors (tacrolimus, sirolimus, cyclosporine, mycophenolate mofetil)

Question 10

How is graft vs host disease treated?

Answer 10

Corticosteroids