CPHON Bone Marrow Transplant and Stem Cell Therapy

Question 1

A pediatric patient undergoing allogeneic hematopoietic stem cell transplant (HSCT) develops a skin rash, diarrhea, and elevated bilirubin 3 weeks post-transplant.
The nurse recognizes this as which complication?

Accepted Answer

Acute graft-versus-host disease (aGVHD)

Answer

Engraftment syndrome

Answer

Veno-occlusive disease

Answer

Cytomegalovirus colitis

Question 2

Which conditioning regimen used prior to HSCT is associated with the highest risk of veno-occlusive disease (VOD)/sinusoidal obstruction syndrome?

Accepted Answer

Myeloablative conditioning with busulfan and cyclophosphamide

Answer

Reduced intensity conditioning with fludarabine

Answer

Non-myeloablative conditioning

Answer

Standard chemotherapy without radiation

Question 3

What is the primary purpose of the preparative (conditioning) regimen given before HSCT?

Accepted Answer

To eradicate residual malignancy and create marrow space for donor cells

Answer

To prevent graft-versus-host disease

Answer

To stimulate stem cell mobilization in the donor

Answer

To induce remission from active disease

Question 4

A child 6 months post-allogeneic HSCT develops dry eyes, oral mucosal changes, joint contractures, and skin tightening. This clinical picture is most consistent with:

Accepted Answer

Chronic graft-versus-host disease (cGVHD)

Answer

Late cytomegalovirus end-organ disease

Answer

Post-transplant lymphoproliferative disorder

Answer

Drug-induced scleroderma

Question 5

What is engraftment, and what laboratory finding confirms that it has occurred following HSCT?

Accepted Answer

Recovery of donor-derived hematopoiesis, confirmed by absolute neutrophil count (ANC) ≥500/µL for 3 consecutive days

Answer

Disappearance of GVHD symptoms

Answer

Platelet count above 100,000/µL

Answer

Return of pre-transplant immunoglobulin levels

Question 6

Which infection is of greatest concern during the pre-engraftment phase of HSCT (days 0–30) when the patient is profoundly neutropenic?

Accepted Answer

Bacterial and fungal infections

Answer

Herpes zoster (VZV)

Answer

Cytomegalovirus (CMV) end-organ disease

Answer

EBV-associated lymphoproliferative disorder