Transplant Types
Patients with Multiple Myeloma, Neuroblastoma, and Lymphoma receive this type of transplant.
What is an Autologous Transplant
This is the most common regimen used for Multiple Myeloma patients prior to transplant.
What is Melphalan.
All patient's need this in order to safely receive their conditioning regimen, to avoid potential extravasation, and ensure accurate infusion of stem cells.
What is a central line (i.e. Trifusion Catheter, PICC, Broviac, etc.)
Donner is 71 year old male with Multiple Myeloma. Donner is on dialysis and is preparing for Autologous stem cell transplant. He has received 4 cycles of Revlimid/Velcade/Dexamethasone (RVD) and is now in a Partial Response. Specify which conditioning regimen would be used for Donner.
What is Reduced Dose Melphalan
Specify why we use conditioning regimens for transplant. (Name one)
What is:
Eradicate disease
Creation of “Space” in the bone marrow for the donor cells to engraft
Immunosuppression to decrease the risk of rejection of the donor cells by the host cells
Patient's with AML and ALL receive this type of transplant.
What is an Allogeneic Transplant
This is the most common myeloablative regimen used for AML patients.
What is Busfulan/Cytoxan
Specify which nursing intervention is used to reduce one of the major side effects of Melphalan.
What is cryotherapy
Cupid is a 64 yo female with Myelodysplastic Syndrome (MDS), who is preparing for a matched unrelated PBSC transplant. Her CMI score is 5 for moderate pulmonary function and a history of breast cancer. Specify which conditioning regimen would be appropriate for her transplant.
What is Fludarabine/Melphalan
Name three factors that affect which conditioning regimen is used for a patient.
What is CMI score, age, donor choice, underlying disease
When a patient has a half-matched donor, they are receiving this type of transplant.
What is a Haploidentical Transplant
This is the most common myeloablative regimen used for patients with ALL.
What is Cytoxan/Total Body Irradiation (TBI)
IV fluids and Mesna are given with this chemotherapy drug to avoid bladder irritation, as it is a common side effect of this drug in high doses.
What is Cytoxan
Rudolph is an 18 year old male with AML and unfortunately does not have any unrelated donors on the registry. His half-matched sibling, who is 15 years old, will be donating bone marrow. Rudolph's CMI score is 0. He is ready for transplant! Specify which conditioning regimen would be used for Rudolph's transplant.
What is Maxi-Haplo Busulfan/Cytoxan
This chemotherapy drug is needed for patients with pediatric ALL, neuroblastoma, CNS lymphoma, or malignancies with CNS or brain involvement.
What is Thiotepa
Some types of diseases, such as Neuroblastoma, brain tumors, and germ cell tumors, require multiple autologous transplants. Specify which type of transplant this is considered.
What is a Tandem Transplant
The most common myeloablative regimen used for patients with lymphoma.
What is BEAM (BCNU or Carmustine, Etoposide, Ara-C or Cytarabine, Melphalan)
These nursing considerations are needed for patient's receiving Busulfan (Please list two)
What is seizure precautions, PK levels, no Tylenol, no alcohol
Vixen is a 69-year-old relapsed lymphoma patient in complete remission (CR) that is preparing to go to autologous stem cell transplant. She has a CMI score of 6 due to a low EF on echo, low DLCO on PFT, and is currently being treated for bi-polar disorder. She has limited caregiver support. Specify the conditioning regimen we would use with this patient.
What is BEAM (BCNU or Carmustine, Etoposide, Ara-C or Cytarabine, Melphalan)
Specify what form of therapy is used in combination with chemotherapy to further eradicate disease and is able to target sanctuary sites, such as gonads and CSF.
What is Total Body Irradiation (TBI)
When you get a transplant from an identical twin, it is called this.
What is a Syngeneic Transplant
This chemotherapy drug is used post-transplant for the Haplo regimens in order to deplete t-cells.
What is Cytoxan
These nursing considerations are needed for patient's receiving Thiotepa. (Please list two)
What is bath and linen changes every 6 hours, no occlusive dressings or skin creams
Dasher is a 14yo male who was diagnosed with AML in 2018 and achieved remission after initial treatment. Dasher unfortunately relapsed in October of 2019 and has been evaluated for a stem cell transplant. His FS is 27%, his lung function is decreased, his liver enzymes are elevated, and his bone marrow biopsy shows no leukemia. The physician wants Dasher to proceed with transplant now that he is in remission, but is concerned about the possibility of Venocclusive Disease (VOD/ SOS) and lung toxicity. Specify which regimen would be considered for Dasher.
What is Busulfan/Fludarabine
This conditioning regimen is used for most non-malignant diseases, such as sickle cell disease and Schwachman Diamond Syndrome. (Hint, there are three drugs included in this regimen)
What is Campath/Fludarabine/Melphalan