AOCNP Hematologic Malignancies 5

Question 1

A 60-year-old with newly diagnosed AML has FLT3-ITD mutation. Which agent should be added to standard induction chemotherapy based on current NCCG guidelines?

Accepted Answer

Midostaurin

Answer

Midostaurin, a FLT3 inhibitor, significantly improves OS when added to standard 7+3 induction in FLT3-mutated AML (RATIFY trial).

Question 2

A patient with Hodgkin lymphoma relapses after ABVD chemotherapy. PET-CT confirms relapsed disease. What is the standard treatment approach for transplant-eligible patients?

Accepted Answer

Salvage chemotherapy followed by autologous stem cell transplant

Answer

Relapsed/refractory Hodgkin lymphoma in transplant-eligible patients is treated with platinum-based salvage chemotherapy followed by high-dose chemotherapy and autologous SCT.

Question 3

Which clinical feature distinguishes essential thrombocythemia (ET) from a reactive thrombocytosis?

Accepted Answer

Presence of JAK2, CALR, or MPL mutation

Answer

Driver mutations (JAK2 V617F, CALR, MPL) confirm clonal thrombocytosis in ET; reactive thrombocytosis has no clonal mutation.

Question 4

A patient with Waldenström macroglobulinemia presents with episodic Raynaud phenomenon, urticaria, and hyperviscosity. Which immunoglobulin class is responsible?

Accepted Answer

IgM

Answer

Waldenström macroglobulinemia is characterized by a monoclonal IgM paraprotein; its large pentameric structure causes hyperviscosity and cold agglutinin/cryoglobulin phenomena.

Question 5

A patient with T-cell acute lymphoblastic leukemia (T-ALL) has a mediastinal mass causing superior vena cava syndrome. Which chemotherapy backbone is most appropriate for induction?

Accepted Answer

Hyper-CVAD or BFM-based multi-agent protocol

Answer

T-ALL is treated with intensive multi-agent protocols such as Hyper-CVAD or BFM, which incorporate L-asparaginase and CNS prophylaxis.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Hematologic Malignancies 5