Bone Marrow Transplant and Stem Cell Therapy Flashcards
6 cards from real CPHON practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Bone Marrow Transplant and Stem Cell Therapy flashcards as text
What is the difference between autologous and allogeneic HSCT, and which type carries risk for graft-versus-host disease?
Answer: Allogeneic uses donor stem cells and carries GVHD risk; autologous uses the patient's own cells and does not
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.
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:
Answer: Hepatic veno-occlusive disease (VOD/SOS)
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).
Which type of donor match provides the best outcomes in pediatric allogeneic HSCT?
Answer: 10/10 HLA-matched sibling donor
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.
What is the graft-versus-leukemia (GVL) effect, and why is it clinically important in allogeneic HSCT?
Answer: Donor T cells attacking residual leukemic cells in the recipient, reducing relapse risk
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.
Which stem cell source typically results in the fastest neutrophil engraftment following HSCT?
Answer: G-CSF mobilized peripheral blood stem cells (PBSC)
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.
A child post-allogeneic HSCT is prescribed tacrolimus and methotrexate. What is the primary purpose of this combination?
Answer: GVHD prophylaxis by suppressing donor T-cell activation and proliferation
Tacrolimus (a calcineurin inhibitor blocking IL-2 production) combined with short-course methotrexate (inhibiting T-cell proliferation) is the standard combination for acute GVHD prophylaxis in allogeneic HSCT.