Stem Cell Transplant

Question 1

What type of transplant is most common?

Answer 1

Auto > Allo

Question 2

Stem cell basics

Answer 2

have CD34

in peripheral blood, bone marrow, cord blood

Question 3

Candidates

Answer 3

allo: 60 y/o auto: 75 y/o
Disease that can handle a high dose of chemo
Healthy organs
Psych healthy and no drugs
Social and funding support

Question 4

Diseases that get auto

self

Answer 4

Mult myeloma
Non Hodgkin’s lymphoma
Solid tumors

Question 5

Diseases that get allo

donor

Answer 5

AML
ALL
CML
CLL
Non-malignancies

Question 6

Sources of stem cells

Answer 6

Bone Marrow
Peripheral Blood
Umbilical Cord Blood

Question 7

Auto transplant issues

olders

Answer 7

Tumor contamination
increased relapse–no graft vs tumor
can be frozen
need high dose chemo

Question 8

Allo transplant issues

young

Answer 8

High relapse in identical twins 
graft vs host disease
need high dose chemo
need immunosuppression afterwards
1/4-1/5 die

Question 9

Reduced intensity allo transplant

Answer 9

CLL, elderly

Question 10

MRD

Answer 10

match (un)related donor

Mismatched (un)related

Question 11

Growth factor used in

Answer 11

both types

but auto needs chemo first

Question 12

HLA matching

Answer 12

most important are
class 1: HLA A B C
class 2: HLA DR

Question 13

Drug that you need to shower 3-4 times a day

Answer 13

thiotepa

Question 14

Treatment for hepatic sinusoidal obstruction syndrome

Answer 14

Anticoagulants
ursodiol prophy
defibrotide

Question 15

GVHD prophy

Answer 15

Cyclosporine, tacrolimus
MTX to kill T-cells
Cyclophos
Steroids
extracorporeal photophoresis

Question 16

GVHD treatment

Answer 16

Cyclosporine, tacrolimus
Steroids
extracorporeal photophoresis
Ibrutinib (chronic)
Rituximab (male -> female mismatch)

Question 17

Relapse treatment

Answer 17

Donor leukocyte infusion
Stop immune suppression
IL-2 or interferon
2nd transplant
targeted chemo

Question 18

Long term effects of SCT

Answer 18

infertile
endocrine dysfx
cataracts
chronic GVHD