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Questions and Answers
Which type of hematopoietic stem cell transplantation (HSCT) allows for administration of high chemotherapy doses?
What is the main goal of hematopoietic stem cell transplantation (HSCT)?
What is the dose-response relationship of cancer treatment limited by?
Which of the following is true about non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?
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Which of the following is true about graft-versus-host disease (GVHD)?
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Which of the following is true about cyclosporine?
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Which of the following is NOT an indication for autologous hematopoietic stem cell transplantation (HSCT)?
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What is the rationale for replacing bone marrow cells autologously in HSCT?
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Which type of stem cell collection requires the use of mobilization to move stem cells from bone marrow to peripheral blood?
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Which type of HSCT requires finding a donor who is an adequate match and carries a risk of graft-versus-host disease?
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Which cells are considered the 'mother' cells for all blood cells?
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What is the most common indication for hematopoietic stem cell transplantation (HSCT) overall?
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Which type of HSCT is used in the upfront setting for consolidation in intermediate or high-risk disease?
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What is the goal of allogeneic HSCT in AML and ALL?
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Which type of stem cell collection requires bone marrow harvest under general anesthesia?
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What is the main difference between autologous and allogeneic HSCT?
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What is the preferred level of HLA matching for allogeneic HSCT?
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What is the purpose of conditioning regimens in HSCT?
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What is the risk of tumor cell contamination in peripheral blood stem cell collection?
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What is the role of hematopoietic stem cells in HSCT?
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Which type of HSCT allows for administration of high chemotherapy doses?
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What is the main goal of hematopoietic stem cell transplantation (HSCT)?
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What is the dose-response relationship of cancer treatment limited by?
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Which type of stem cell collection requires the use of mobilization to move stem cells from bone marrow to peripheral blood?
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Which of the following is NOT an indication for autologous hematopoietic stem cell transplantation (HSCT)?
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What is the rationale for replacing bone marrow cells autologously in HSCT?
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Which of the following is true about graft-versus-host disease (GVHD)?
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Which of the following is true about cyclosporine?
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Which of the following is true about non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?
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Which type of HSCT requires finding a donor who is an adequate match and carries a risk of graft-versus-host disease?
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Which of the following is a goal of non-myeloablative/reduced intensity hematopoietic stem cell transplantation (HSCT)?
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Which of the following is NOT a dose limiting toxicity in hematopoietic stem cell transplantation (HSCT)?
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Which of the following is a target goal for cyclosporine levels in hematopoietic stem cell transplantation (HSCT)?
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Which of the following is NOT a supportive care measure in hematopoietic stem cell transplantation (HSCT)?
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Which of the following is a potential long-term complication of hematopoietic stem cell transplantation (HSCT)?
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Which of the following is true about graft-versus-host disease (GVHD) in hematopoietic stem cell transplantation (HSCT)?
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Which of the following is NOT an interaction of cyclosporine with other drugs?
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Which of the following is a potential indication for autologous hematopoietic stem cell transplantation (HSCT)?
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Which of the following is true about the dose-response relationship in cancer treatment?
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Which of the following is true about the involvement of pharmacists in hematopoietic stem cell transplantation (HSCT)?
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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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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).
