Stem Cell Transplantation Overview
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the required criteria for absolute neutrophil count (ANC) to consider engraftment successful?

  • ANC > 0.5 X 10<sup>9</sup> cells per liter
  • ANC > 500 cells/mm<sup>3</sup> (correct)
  • ANC > 1.0 X 10<sup>9</sup> cells per liter
  • ANC > 250 cells/mm<sup>3</sup>

    • During which phase after a stem cell transplant does the nadir typically occur?

  • Day 100
  • Day 30
  • Day 10 (correct)
  • Day 0

    • What percentage of patients receiving stem cell transplants experience acute graft versus host disease (GVHD)?

  • 75%
  • 30%
  • 50% or more (correct)
  • 25%

    • Which of the following is NOT a criterion for assessing engraftment?

    <p>Presence of transfusion requirements</p> Signup and view all the answers

    What complication is characterized by the donor's white blood cells attacking the recipient's body tissues?

    <p>Acute graft versus host disease (GVHD)</p> Signup and view all the answers

    What treatment may be administered to help recover white blood cell counts during neutropenia?

    <p>Colony-stimulating factor</p> Signup and view all the answers

    Which organ is NOT commonly affected by acute graft versus host disease (GVHD)?

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

    What is the primary risk associated with the nadir period following stem cell transplant?

    <p>Risk of infection</p> Signup and view all the answers

    What is a significant challenge faced by infused hemopoietic stem cells during transplantation?

    <p>The recipient’s immune system may recognize them as foreign.</p> Signup and view all the answers

    Which of the following statements about hemopoietic stem cell sources is correct?

    <p>Bone marrow provides a lower incidence of graft vs. host disease compared to peripheral blood.</p> Signup and view all the answers

    What does the term 'HLA match' refer to?

    <p>The number of HLA molecules shared between donor and recipient.</p> Signup and view all the answers

    Why is there a risk of HLA disparity in cord blood stem cell transplantation?

    <p>Cord blood has a smaller volume of available cells.</p> Signup and view all the answers

    What function do HLA antibodies serve in a stem cell transplantation context?

    <p>They can attack transplanted cells that don't match the recipient’s HLA.</p> Signup and view all the answers

    What is a disadvantage of utilizing peripheral blood stem cells over bone marrow?

    <p>They result in a higher incidence of graft vs. host disease.</p> Signup and view all the answers

    During a stem cell transplant, what is generally required post-infusion?

    <p>Monitoring for signs of opportunistic infections.</p> Signup and view all the answers

    What does stem cell transplant typically occur after?

    <p>An extensive preparation of the recipient including chemotherapy.</p> Signup and view all the answers

    What is the main advantage of autologous stem cell transplants?

    <p>No foreign antigens present</p> Signup and view all the answers

    Which type of donor is considered a matched related donor in allogeneic transplants?

    <p>A sibling with shared HLA antigens</p> Signup and view all the answers

    What is myeloablation most commonly associated with in patient preparation for transplant?

    <p>Eliminating native blood stem cells</p> Signup and view all the answers

    What defines the success of engraftment after a stem cell transplant?

    <p>Maintenance of a minimum number of white blood cells for a certain duration</p> Signup and view all the answers

    In allogeneic transplants, which of the following describes a mismatched family donor?

    <p>A close relative without common HLA antigens</p> Signup and view all the answers

    Which treatment is a common agent used in the myeloablation regime?

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

    How long does the engraftment process typically take from the time of transplantation?

    <p>14-28 days</p> Signup and view all the answers

    What is the key feature of syngeneic transplants?

    <p>Stem cells derived from an identical twin</p> Signup and view all the answers

    What activities should be avoided for up to one year after receiving a transplant?

    <p>Contact sports, yoga, household chores</p> Signup and view all the answers

    Which test is NOT included in the evaluation for subacute transplant patients?

    <p>Quality of Life Assessment</p> Signup and view all the answers

    What is the primary reason for improved outcomes in heart transplantation since the first surgery in 1967?

    <p>Improved immunosuppressive drugs</p> Signup and view all the answers

    Which of the following conditions is a contraindication for heart transplantation?

    <p>Chronic liver disease</p> Signup and view all the answers

    What is the median survival range for adult heart transplant recipients?

    <p>10.7 to 12.2 years</p> Signup and view all the answers

    What is the key difference between orthotopic and heterotopic heart transplant?

    <p>Orthotopic involves replacing the recipient's heart while heterotopic does not</p> Signup and view all the answers

    Which factors are taken into account in the matching process for a heart transplant?

    <p>Blood type, disease severity, and geographical proximity</p> Signup and view all the answers

    What percentage represents the one-year survival rate for heart transplant recipients?

    <p>82%</p> Signup and view all the answers

    Which activity is considered low impact and is advisable during the subacute stage post-transplant?

    <p>Aerobic exercise</p> Signup and view all the answers

    Which of the following tests is NOT typically part of the pre-transplant evaluation?

    <p>Thyroid function test</p> Signup and view all the answers

    How does the mortality rate change in heart transplant patients after the first six months?

    <p>It decreases to 3.4% per year</p> Signup and view all the answers

    What can lead to rejection of a donor heart by the transplant team?

    <p>Mismatch in tissue type (HLA)</p> Signup and view all the answers

    What was the outcome of the first heart transplant performed in 1967?

    <p>Patient died 18 days after the procedure</p> Signup and view all the answers

    Which immunosuppressive drug is known as a renal toxin?

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

    What is a common result of chronic rejection after heart transplantation?

    <p>Transplant Coronary Artery Disease (TCAD)</p> Signup and view all the answers

    What is the recommended frequency for heart biopsies after the first month post-transplant?

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

    Which physiological alteration is characterized by the inability to increase the heart rate appropriately?

    <p>Chronotropic incompetence</p> Signup and view all the answers

    What is a significant musculoskeletal alteration observed in heart transplant recipients?

    <p>Decreased oxidative enzyme capacity</p> Signup and view all the answers

    During physical activity, how is heart rate and cardiac output regulated in a transplanted heart?

    <p>Both circulating catecholamines and Bainbridge reflex</p> Signup and view all the answers

    What is the size of the tissue sample collected during a cardiac biopsy?

    <p>Size of a pin</p> Signup and view all the answers

    What type of drug is prednisone classified as in heart transplantation?

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

    Study Notes

    Stem Cell Transplantation

    • Goal: Replace diseased bone marrow with healthy stem cells to produce functional blood cells. This normalizes hematopoiesis, the process by which the body produces blood cells.
    • Diseases Treated: Primarily blood tumors like leukemia, lymphoma, multiple myeloma, and myelodysplastic syndromes. Also used for neuroblastoma, Ewing sarcoma, brain tumors, germ cell tumors, and testicular cancer in children.
    • Stem Cell Types: Two main types:
      • Embryonic stem cells: Can differentiate into any cell type, have high plasticity, and are potential treatments for diseased organs and tissues.
      • Adult stem cells (somatic stem cells): Found in tissues and organs, differentiate into specialized cell types of that tissue or organ.
    • Hematopoietic Stem Cells:
      • The originating cell and stem cell
      • Differentiation: Process immature cells mature cells with specific functions.
      • Types: Myeloid stem cell, Lymphoid stem cell, Hematopoietic stem cells
    • Bone Marrow: Common source of stem cells; lower incidence of graft rejection and quicker engraftment.
    • Peripheral Blood Stem Cells: Quicker engraftment, greater risk of GVHD.
    • Umbilical Cord Blood: Contains stem cells; has lower stem cell count and longer engraftment period.
    • Sources of Hemopoietic Stem Cells: Bone marrow, peripheral blood stem cells, umbilical cord blood.
    • Types of Transplants:
      • Autologous: Stem cells collected from the patient and reinjected; low rejection risk.
      • Syngeneic: Stem cells from an identical twin; reduced rejection risk.
      • Allogeneic: Stem cells from a matching donor; higher rejection risk (graft-vs-host disease), is the most common source of bone marrow transplant.
    • Patient Preparation: Myeloablation, chemotherapy, and whole-body radiation to destroy the patient's native blood cells and makes way for new cells.
    • Infusion: Stem cells are infused into the patient after myeloablation.
    • Engraftment: The process where transplanted stem cells migrate to bone marrow, establish a stem cell population, and start producing new blood cells. (takes 14-28 days for complete development).
    • Nadir: Lowest point of blood cell counts after transplantation, this period has greatest risk of infection.
    • Graft vs. Host Disease (GVHD): A serious complication where the donor's immune cells attack the recipient's tissues.
    • Tissue Matching: Matching HLA (Human Leukocyte Antigens) is critical for reducing rejection risk.
    • Post-transplant setting: Includes isolation; good days, bad days, family involved; monitor blood counts; in-room and out-of-room exercise programs; 6 min walk test, cycling test, balancing exercises.
    • Subacute setting: 30-100 days after the transplant, limitations are present, includes out-patient vs HEP, ports, avoid high impact activities, monitor blood counts.
    • Exercise Behavior: Patient's exercise patterns vary, with some post-transplant recovery.
    • Physical Functional Status: Exercise impact on physical status, measured by strength.
    • Heart Transplant: Discusses candidates, types of procedures (orthotopic, heterotropic), contraindications, pre-transplant evaluation, the matching process, immunosuppression, early problems (renal failure, rejection), and cardiac biopsy. (Also contains information on physical activity, post-transplant CV & skeletal muscle alterations, effects of exercise, and exercise protocols)
    • Lung Transplant: Covers reasons for transplantation (COPD, interstitial lung disease, cystic fibrosis, pulmonary hypertension), factors affecting eligibility, surgical procedure, methods for transporting the lungs and connections to the recipient's body, complications, post-transplant care, and preservation techniques.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Stem Cell Transplantation PDF

    Description

    Explore the fundamentals of stem cell transplantation, including its goal of replacing diseased bone marrow with healthy stem cells. This quiz covers the diseases treated, types of stem cells, and the process of hematopoiesis, essential for producing functional blood cells.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser