Hematopoietic Stem Cell Transplantation (HSCT)
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Questions and Answers

Which type of hematopoietic stem cell transplantation (HSCT) allows for administration of high chemotherapy doses?

  • Umbilical cord blood HSCT
  • Autologous HSCT (correct)
  • Peripheral blood HSCT
  • Allogeneic HSCT

    • What is the main goal of hematopoietic stem cell transplantation (HSCT)?

  • To create a graft-versus-tumor effect
  • To replace diseased bone marrow with healthy bone marrow
  • To restore normal functioning of bone marrow
  • To rescue a patient following complete eradication of marrow with ablative pre-transplant chemotherapy (correct)

    • What is the dose-response relationship of cancer treatment limited by?

  • Toxicities (cardiac, neuro, renal, etc.)
  • Myelosuppression (correct)
  • Chemotherapy resistance
  • Hematopoiesis

    • Which of the following is true about non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?

    <p>It is associated with a higher risk of relapse.</p> Signup and view all the answers

    Which of the following is true about graft-versus-host disease (GVHD)?

    <p>It occurs when the donated stem cells or bone marrow attack the patient's healthy tissues.</p> Signup and view all the answers

    Which of the following is true about cyclosporine?

    <p>It is a substrate of CYP3A4.</p> Signup and view all the answers

    Which of the following is NOT an indication for autologous hematopoietic stem cell transplantation (HSCT)?

    <p>Leukemia</p> Signup and view all the answers

    What is the rationale for replacing bone marrow cells autologously in HSCT?

    <p>To rescue and reset the bone marrow</p> Signup and view all the answers

    Which type of stem cell collection requires the use of mobilization to move stem cells from bone marrow to peripheral blood?

    <p>Peripheral blood stem cell collection</p> Signup and view all the answers

    Which type of HSCT requires finding a donor who is an adequate match and carries a risk of graft-versus-host disease?

    <p>Allogeneic HSCT</p> Signup and view all the answers

    Which cells are considered the 'mother' cells for all blood cells?

    <p>Hematopoietic stem cells</p> Signup and view all the answers

    What is the most common indication for hematopoietic stem cell transplantation (HSCT) overall?

    <p>Lymphomas</p> Signup and view all the answers

    Which type of HSCT is used in the upfront setting for consolidation in intermediate or high-risk disease?

    <p>Allogeneic HSCT</p> Signup and view all the answers

    What is the goal of allogeneic HSCT in AML and ALL?

    <p>To rescue and replace the bone marrow</p> Signup and view all the answers

    Which type of stem cell collection requires bone marrow harvest under general anesthesia?

    <p>Bone marrow stem cell collection</p> Signup and view all the answers

    What is the main difference between autologous and allogeneic HSCT?

    <p>Autologous HSCT requires finding a fully matched donor, while allogeneic HSCT does not</p> Signup and view all the answers

    What is the preferred level of HLA matching for allogeneic HSCT?

    <p>10/10 match</p> Signup and view all the answers

    What is the purpose of conditioning regimens in HSCT?

    <p>To wipe out the bone marrow</p> Signup and view all the answers

    What is the risk of tumor cell contamination in peripheral blood stem cell collection?

    <p>Minimal risk</p> Signup and view all the answers

    What is the role of hematopoietic stem cells in HSCT?

    <p>To make healthy blood cells</p> Signup and view all the answers

    Which type of HSCT allows for administration of high chemotherapy doses?

    <p>Allogeneic HSCT</p> Signup and view all the answers

    What is the main goal of hematopoietic stem cell transplantation (HSCT)?

    <p>To create a graft-versus-tumor effect (allogeneic transplant)</p> Signup and view all the answers

    What is the dose-response relationship of cancer treatment limited by?

    <p>Myelosuppression</p> Signup and view all the answers

    Which type of stem cell collection requires the use of mobilization to move stem cells from bone marrow to peripheral blood?

    <p>Autologous HSCT</p> Signup and view all the answers

    Which of the following is NOT an indication for autologous hematopoietic stem cell transplantation (HSCT)?

    <p>Aplastic anemia</p> Signup and view all the answers

    What is the rationale for replacing bone marrow cells autologously in HSCT?

    <p>To restore normal functioning of bone marrow</p> Signup and view all the answers

    Which of the following is true about graft-versus-host disease (GVHD)?

    <p>It is a complication of allogeneic HSCT</p> Signup and view all the answers

    Which of the following is true about cyclosporine?

    <p>It is used to prevent graft-versus-host disease (GVHD)</p> Signup and view all the answers

    Which of the following is true about non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?

    <p>It is used in patients with advanced age or comorbidities</p> Signup and view all the answers

    Which type of HSCT requires finding a donor who is an adequate match and carries a risk of graft-versus-host disease?

    <p>Allogeneic HSCT</p> Signup and view all the answers

    Which of the following is a goal of non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?

    <p>To achieve a high graft-versus-tumor effect</p> Signup and view all the answers

    Which of the following is NOT a dose limiting toxicity in hematopoietic stem cell transplantation (HSCT)?

    <p>Myelosuppression</p> Signup and view all the answers

    Which of the following is a target goal for cyclosporine levels in hematopoietic stem cell transplantation (HSCT)?

    <p>150-450 ng/mL</p> Signup and view all the answers

    Which of the following is NOT a supportive care measure in hematopoietic stem cell transplantation (HSCT)?

    <p>Antibiotic prophylaxis</p> Signup and view all the answers

    Which of the following is a potential long-term complication of hematopoietic stem cell transplantation (HSCT)?

    <p>Organ damage</p> Signup and view all the answers

    Which of the following is true about graft-versus-host disease (GVHD) in hematopoietic stem cell transplantation (HSCT)?

    <p>It is caused by the patient's immune system attacking the donor cells</p> Signup and view all the answers

    Which of the following is NOT an interaction of cyclosporine with other drugs?

    <p>Nephrotoxicity</p> Signup and view all the answers

    Which of the following is a potential indication for autologous hematopoietic stem cell transplantation (HSCT)?

    <p>Relapsed/refractory lymphoma</p> Signup and view all the answers

    Which of the following is true about the dose-response relationship in cancer treatment?

    <p>Chemotherapy doses in HSCT are lower than typical chemotherapy doses</p> Signup and view all the answers

    Which of the following is true about the involvement of pharmacists in hematopoietic stem cell transplantation (HSCT)?

    <p>Pharmacists are involved in monitoring immunosuppression levels</p> Signup and view all the answers

    Study Notes

    Hematopoietic Stem Cell Transplantation (HSCT) Overview

    • High-dose chemotherapy is best delivered through myeloablative HSCT.
    • The primary goal of HSCT is to replace diseased or damaged bone marrow to restore normal blood cell production.
    • Cancer treatment's dose-response relationship is limited by toxicity to healthy tissues.

    Types of HSCT

    • Non-myeloablative/reduced intensity HSCT has a milder conditioning regimen and is used for patients who are not candidates for full-intensity approaches.
    • Allogeneic HSCT requires locating a genetically matched donor and has an associated risk of graft-versus-host disease (GVHD).
    • Autologous HSCT uses the patient’s own stem cells and is indicated for certain malignancies, but oncology indications vary.

    Stem Cell Collection

    • Mobilization is essential for peripheral blood stem cell collection, moving cells from bone marrow to bloodstream.
    • Bone marrow harvest requires general anesthesia and is a more invasive collection method than peripheral collection.

    Indications and Rationale

    • Common indications for autologous HSCT include multiple myeloma and specific lymphomas, while leukemia is often treated with allogeneic options.
    • The rationale for autologous HSCT is to replace the patient’s own compromised bone marrow cells with healthy ones.

    Graft-versus-Host Disease (GVHD)

    • GVHD occurs when donor immune cells attack the recipient's tissues, leading to potential complications.
    • Cyclosporine is an immunosuppressant used to prevent GVHD, with target serum levels monitored in patients post-transplant.

    Risk Management and Long-Term Complications

    • Tumor cell contamination risk exists in peripheral blood stem cell collection, necessitating careful screening.
    • Long-term complications can include cardiovascular issues, secondary malignancies, and chronic GVHD.

    Other Key Facts

    • Hematopoietic stem cells, termed 'mother' cells, are responsible for producing all types of blood cells.
    • Preferred HLA matching for allogeneic HSCT is typically 8/8 alleles to minimize rejection risk.
    • Condition regimens serve to eradicate diseased cells and immunosuppress the patient to facilitate successful engraftment.

    Pharmacist's Role

    • Pharmacists play a crucial role in managing medication regimens, adjusting dosages, and monitoring interactions especially in HSCT patients.

    Additional Insights

    • The goal of allogeneic HSCT in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) is often to achieve complete remission and prevent relapse.
    • Understanding the dose-response relationship helps in determining optimal therapeutic levels while avoiding severe adverse effects.

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    Related Documents

    HSCT 2023.pptx

    Description

    Test your knowledge on hematopoietic stem cell transplantation (HSCT) with this quiz. Learn about the rationale for autologous and allogeneic HSCT, selection of donor type, and the different types of HSCT. Compare and contrast HSCT types and conditioning regimens, and understand the risk/benefit considerations. Identify supportive care needs for HSCT and strategies for preventing and treating graft-versus-host disease (GVHD).

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