CPHON Bone Marrow Transplant and Stem Cell Therapy 2

Question 1

What is the difference between autologous and allogeneic HSCT, and which type carries risk for graft-versus-host disease?

Accepted Answer

Allogeneic uses donor stem cells and carries GVHD risk; autologous uses the patient's own cells and does not

Answer

Allogeneic HSCT uses stem cells from a matched donor (sibling, unrelated, or cord blood), and the immunologic mismatch between donor T cells and host tissues is the basis for GVHD. Autologous HSCT uses the patient's own stored stem cells, so GVHD does not occur.

Question 2

A child receiving allogeneic HSCT develops sudden weight gain, right upper quadrant pain, and jaundice on day 10 post-transplant. Labs show elevated bilirubin and transaminases. The nurse suspects:

Accepted Answer

Hepatic veno-occlusive disease (VOD/SOS)

Answer

VOD/SOS typically presents in the first 30 days post-transplant with the classic triad of painful hepatomegaly/right upper quadrant pain, fluid retention/weight gain >2%, and hyperbilirubinemia (>2 mg/dL).

Question 3

Which type of donor match provides the best outcomes in pediatric allogeneic HSCT?

Accepted Answer

10/10 HLA-matched sibling donor

Answer

A fully HLA-matched sibling donor (10/10 allele-level match) provides the best outcomes with the lowest rates of graft rejection, acute GVHD, and transplant-related mortality.

Question 4

What is the graft-versus-leukemia (GVL) effect, and why is it clinically important in allogeneic HSCT?

Accepted Answer

Donor T cells attacking residual leukemic cells in the recipient, reducing relapse risk

Answer

The GVL effect refers to donor T and NK cells recognizing and eliminating residual host leukemic cells that express alloantigens, providing an immune-mediated anti-tumor effect that reduces relapse rates.

Question 5

Which stem cell source typically results in the fastest neutrophil engraftment following HSCT?

Accepted Answer

G-CSF mobilized peripheral blood stem cells (PBSC)

Answer

G-CSF-mobilized peripheral blood stem cells contain the highest CD34+ progenitor cell content, resulting in faster neutrophil and platelet engraftment compared to bone marrow or cord blood.

CPHON Exam Practice Test

CPHON Exam Practice Test

CPHON Bone Marrow Transplant and Stem Cell Therapy 2