Stem Cell

Question 1

The below cells are ___

NK cells
adaptive WBCs

a. myeloid
b. lymphoid

Answer 1

b. lymphoid

Question 2

The below cells are ___

RBCs
platelets
innate WBCs

a. myeloid
b. lymphoid

Answer 2

a. myeloid

Question 3

3 sources of stem cells?

Answer 3

• peripheral blood stem cells through leukapheresis
• umbilical cord
• bone marrow from ileac crest

Question 4

3 mobilization drugs?

Answer 4

• granulocyte colony stimulating factor (G-CSF)
• granulocyte macrophage CSF
• plerixafor when combined with filgrastim

Question 5

G-CSF mechanism of action?

Answer 5

stimulates production, maturation, and activation of neutrophils

Question 6

G-CSF onset is __ to __ days

Answer 6

1, 2

Question 7

What is the main side effect of G-CSF?

Answer 7

bone pain

Question 8

GM-CSF onset is __ to __ days

Answer 8

7, 14

Question 9

___ stimulates production, maturation, and activation of neutrophils, eosinophils, monocytes, and macrophages

a. G-CSF
b. GM-CSF

Answer 9

b. GM-CSF

Question 10

GM-CSF is contraindicated in pts with an allergy to __ derived products

Answer 10

yeast

Question 11

___ has AEs of capillary leak syndrome, infusion reactions, skin changes

a. G-CSF
b. GM-CSF

Answer 11

b. GM-CSF

Question 12

What is plerixafor onset time?

Answer 12

6-9hrs

Question 13

Pts should use a backup method of contraception for how long after plerixafor use?

Answer 13

1 week

Question 14

Plerixafor must be given with or after ___

Answer 14

filgrastim

Question 15

What is main AE of peripheral blood stem cell (PBSC) donation?

Answer 15

bone pain

Question 16

Pts should receive daily injections mobilizing agent about __ days before peripheral blood stem cell (PBSC) donation

Answer 16

5

Question 17

___ is preparative chemotherapy to increase likelihood go engraftment

Answer 17

conditioning regimen

Question 18

___ is high dose chemo +/- radiation that would cause life threatening myelosuppression if not rescued by infusion of new stem cells

Answer 18

myeloablative conditioning (MAC)

Question 19

___ conditioning regimen may be more feasible in less fit patients

a. MAC
b. RIC

Answer 19

b. RIC

Question 20

Which conditioning method has a possible graft vs malignancy benefit?

a. MAC
b. RIC

Answer 20

b. RIC

Question 21

___ is required for autologous

a. MAC
b. RIC

Answer 21

a. MAC

Question 22

RIC is only available for ___

a. autologous
b. allogeneic

Answer 22

b. allogeneic

Question 23

___ HSCT has high risk for complications

a. autologous
b. allogeneic

Answer 23

b. allogeneic

Question 24

Goal is typically cure with ___ HSCT

Answer 24

allogeneic

Question 25

2 most common immunosuppression regiments for GVHD prophylaxis?

Answer 25

• calcineurin inhibitor + anti-proliferative
• T cell depleting

Antiproliferatives:

• methotrexate
• mycophenolate

T cell depleting:

• ATG
• alemtuzumab

Question 26

Acute GVHD occurs within __ days of transplant

Answer 26

100

Question 27

3 main organs/systems affected by acute GVHD?

Answer 27

skin
liver
GI

Liver: elevated alk phos

Question 28

___ GVHD can impact all organs

a. acute
b. chronic

Answer 28

b. chronic

not limited to skin, liver, GI

prophylaxis strategies similar to prevention of acute GVHD:

• CNI + anti-proliferative
• T cell depleting

Question 29

Anticipated neutropenia > __ days is high risk for infection

Answer 29

10

Question 30

What virus are we worried about with allogeneic HSCT that were aren’t with autologous?

Answer 30

CMV

give letermovir for prevention