Car T
How many days, post Car T infusion, do you give the clinicians a copy of the neuro screen?
7 days
How many days post transplant should a patient receive IV fluids?
21 days
How do you check if medications are compatible?
Micromedex - IV Compatability
How many days post transplant are patient's typically on IV Prograf? We are looking for a range of days
19-21 days
Do you need a verified a verified weight for a flat dose chemotherapy medication?
*Daily Double to Follow*
YES!
*Daily Double*
What three flat dose medications do we need verified weights for?
A Car T patient arrives to clinic and has a fever and is newly requiring a nasal cannula for O2 support. What would you suspect?
*Daily double question to follow
CRS (AND rule out infection)
*Daily Double: Grade 2
How long do auto transplants stay on their antifungals, antibiotics and antivirals post transplant?
Until count recovery.
How often should Chimerisms be drawn?
*Daily Double* What are we checking for when we draw a chimerism?
30, 60, 100
Daily Double- Engraftment, Donor cells > Patient
When should CMV levels be drawn post transplant?
*Daily Double* Explain the frequency of surveillance vs. active CMV treatment.
Starting on Day 1
*Surveillance CMV levels should be drawn once weekly. If a patient is on active CMV treatment, levels should be drawn twice weekly.
When using a video interpreter for a consent, what four things do you need to fill out the "interpreter" section on the consent?
1. Name
2. Interpreter Number
3. Date
4. Time
Describe the symptoms of cytokine release syndrome. *Daily Double* What medication is given for emergent treatment of CRS?
hypotension, fever, respiratory failure. Med given: Tociluzimab
When do auto transplant typically start getting re-vaccinated?
3-4 months post auto transplants
How often should you get vitals for any titrated medication?
Baseline, 15min x2, every rate change, end.
Why would a patient be on prograf and sirolimus at the same time?
When trying to taper off one immunosuppressive to another.
What is the term for a local venous response caused by a sensitivity or reaction to a medication?
Flare Reaction
How many days, post Car T infusion, do you draw, phos, uric acid, CRP, ferratin + SOC labs?
14 days
When do patients start receiving Zarxio after their auto transplant?
D+6
(side note: this also applies to MUDs)
If your BMT patient is having a neutropenic fever, but they have a penicillin allergy, what antibiotics would be ordered?
Azactam and Vanco (or dapto)
When do patient's start prograf after PTCy?
24 hours after the completion of the Cytoxan
How many minutes do you wait in between EpiPen's?
5 min
Define ICANS and some of its side effects.
*Daily Double* What does ICANS stand for?
Neurotoxicity associated with a Car-T infusion.
Confusion, delirium, altered mental status
**Immune effector cell-associated neurotoxicity syndrome
When are patient's typically discharged back to their referring oncologist post transplant?
Around day +30
What is the threshold, for Urine Protein, to hold Bevacizumab after a **24hr urine**?
*Daily Double* How long are the 24hr urine results 'good for'?
Urine Protein= 2grams (2000mg)
Daily Double --3 months
What criteria must be met to draw an EBV level?
Cord blood transplant, ATG or Campath
What six things should you do if your patient experiences an amino acid extravasation?
1. Stop the pump
2. Call APP/Pharmacy/Leadership
3. Aspirate
4. Pull IV (DONT APPLY PRESSURE)
5. Apply Ice & Elevate Arm
6. Give Hyaluronidase (5 SQ injections clockwise around extravasation)