Acute GVHD
Rash/profuse diarrhea and/or liver disease within first 30 days after SCT or DLI
What is acute Graft Vs. Host Disease?
First line treatment for grades 2 -4 GVHD
What are systemic steroids?
Mismatch that can cause rapid and fatal acute hemolytic reaction
What is Major ABO incompatibility?
Fluconazole or Itraconazole
What is first-line fungal prophylaxis?
Dryness of oral mucosa from preparative regimen. May persist for months post transplant
What is xerostomia?
Skin or gut biopsy
What is the "gold standard" to diagnose acute GVHD?
Budesonide and oral beclamethasone
What are topical steroids for GI GVHD?
Hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia
What are electrolyte derangements associated with TLS?
Most common infectious syndrome in HSCT
What is CMV?
Lack of initial engraftment of donor stem cells
What is primary graft failure?
Rapid development of skin rash/fever/hepatic dysfunction and diarrhea before engraftment?
What is Hyperacute GVHD?
Used for prevention and/or treatment of GVHD - may cause infusion reaction
What is ATG?
Rare complication of neutropenia, abdominal pain, nausea, bloody diarrhea
What is typhlitis?
Source of stem cells that greatly reduce the risk of infections
What is mobilized peripheral blood stem cells?
Chemotherapy associated with CHF, pericarditis and arrhythmias
What is cyclophosphamide?
GVHD that occurs during taper or withdrawal of immunosuppressants
What is Classic Acute GVHD?
mTor inhibitor that is only available in oral formulation. SE's include pulmonary toxicity
What is sirolimus?
Simultaneous development of clotting and bleeding
What is DIC?
Used to prevent PCP
What is TMP - SMX (Bactrim)
Symptoms include weight gain, tachypnea, pulmonary edema, peripheral edema, crackles in lungs
What is fluid overload?
Requires bowel rest (NPO including oral medications) and use of TPN
GI GVHD
CNI (cyclosporine or tacrolimus) and short course of methotrexate.
What is standard GVHD prevention?
Systemic inflammatory syndrome that occurs during engraftment with symptoms of fever, hypoxemia, weight gain and rash
What is engraftment syndrome?
FACT SCT unit recommendations to decrease infections
What is HEPA filtration, positive air pressure and private rooms with sealed doors?
Significant post transplant disease directly related to EBV
Post transplant lymphoproliferative disease