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BMTCN CH.03 WITH 100% CORRECT ANSWERS
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BMTCN - CHAPTER 5 (INTRO ANDACUTE GVHD) QUESTIONS AND
ANSWERS
What is graft vs host disease? - answer Donor T cells recognize antigens on cells in the recipients
organs as foreign and mount an immunologic repsonse
What are the two categories of GVHD? What determines the category? - answer Acute and
chronic. Clinical manifestations categorize GVHD
What does acute GVHD present as? - answer Erythematous, maculopapular rash, nausea,
vomiting, anorexia diarrhea, ileus, liver disease that occurs within 100 days after transplant, DLI
What is presistent, recurrent, or late onset acute GVHD present as? - answer Features of acute
GVHD AND occurs beyond 100 days post-transplant OR DLI
When does acute GVHD often occur? - answer During taper or withdrawal of
immunosuppressants
What are the manifestations of chronic GVHD? - answer Autoimmune diseases and NO
characteristic of acute GVHD, involves multiple organs (GI, eyes, skin, oral, lung,, liver)
When are most cases of chronic GVHD diagnosed? - answer Within the first year post transplant
What is overlap syndrome in GVHD? - answer When features of both chronic and acute appear
together
What is hyperacute GVHD? - answer Severe form of acute GVHD
, What are the symptoms of hyperacute GVHD? - answer -fever
-rash before engraftment
-hepatic dysfunction
-development of greenish diarrhea with more than 5 stools per day
What is the treatment for hyperacute GVHD? - answer high dose steroids
What are the risk factors for the development of GVHD? - answer -degree fo HLA mismatch
-PBSC as graft source
-Sex mismatch: greater risk with previously childbearing female donor TO a male recipient
-donors older than 40 yr
-hgih doses of TBI
-conditioing intensity (myeloablative)
-higher CD34 cell dose
-GVHD prophylaxis
-unmaipulated graft (not depleted T cells)
-donor transfusion status
-related vs unrelated (more severe GVHD occurs with HLA mismatched or unrelated donors
compared with HLA matched siblings
What are the requirements of GVHD? - answer 1. graft must contain immunocompetent cells
2. histoincompatibility must exist between donor and recipient.
3. recipient must be incapable of mounting an effective immunologic reaction against the graft
Describe the first phase of the patho of GVHD - answer Pre-transplant damage to host tissues =
mucosa is more permeable = large amounts of cytokines (TNF and IL1) = cytokines upregulate
major and minor histocompatibility complexes on host tissue = makes it easy for donor T cells to
recognize host tissue as foreign and mount inflammatory response
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