Foundations of HSCT and Cellular Therapy
A hematopoietic stem cell will become one of either two cell lineages. What are those two lineages called?
Myeloid lineage or lymphoid lineage
What is a common side effect a donor may experience while on the apheresis machine?
hypocalcemia (tingling in lips/extremeties)
Long-term corticosteroid therapy increases the risk of what serious bone complication?
Avascular Necrosis
Your patient asks you what to expect in terms of CRS after their CAR-T transplant. What would you tell them are common signs and symptoms of CRS?
Fevers, hypoxia, hypotension, tachycardia
List some of the factors that are involved when we discuss Quality of Life
Physical wellbeing - are they able to move well? Is there pain?
Social wellbeing - do they have meaningful relationships & are they able to maintain them after transplant?
Psychological - depression, anxiety
Spiritual
What is the biggest advantage of using bone marrow over peripheral blood?
Reduced Risk of GVHD
What drug used for conditioning puts a patient at risk for seizures and infertility?
Busulfan
What common medication used for conditioning can lead to pulmonary toxicity in the future?
Fludarabine
What two markers are followed to monitor for CRS post CAR-T infusion?
Ferritin and C-Reactive protein
What organization inspects, oversees, and encourages standardization of practices in transplant centers?
FACT - Foundations for the Accreditation of Cellular Therapy
Which GVHD prophylaxis regimen enabled the use of haploidentical donors for transplantation?
Post-transplant cyclophosphamide
What causes shortness of breath, hypoxia, and throat itchiness during and cryopreserved stem cell infusion?
DMSO - Dimethyl sulfoxide
What test is used to confirm ocular GVHD?
Schirmer's test
What long term side effect can we see after a CAR-T that may lead to transfusion dependence or infection?
Pancytopenia
What are risk factors for infertility in transplant patients?
Pre-transplant chemos and alkylating agents such as busulfan, cytoxan, and melphalan
Treatment with radiation
Older age
What is the term for evaluating a donor’s physical health, eligibility, and history of infectious or communicable diseases to ensure they are safe to donate?
Donor suitability and eligibility
What is another site for bone marrow collection if volume collected from the iliac crest is inadequate?
The sternum
How do we confirm diagnosis of VOD or SOS?
Liver ultrasound/doppler studies and a liver biopsy
What is the treatment of choice for a patient experiencing neurotoxicity?
Steroids
List some nonpharmacological interventions for the psychosocial effects after transplant such as anxiety, etc.
Exercise, therapy, meditation, deep breathing
DLI is most effective for which disease?
CML
What modifications are done to stem cell products that are ABO incompatible to minimize the risk of reaction?
Red Cell Reduction
Describe TMA
It is a process that involves creating an environment of excessive clotting in the microcirculation. Often associated with CNI use like Tacro. Can lead to renal dysfunction and other organ damage
What disorder involves a hyperinflammatory state, and could cause fever, splenomegaly, multi-organ failure, hyperferritinemia, and hypertriglyceridemia?
HLH or Hemophagocytic Lymphohistiocytosis
What is the timeframe that live vaccines such as the MMR and VZV can be given after transplant?
2 years after transplant