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BMTCN EXAM QUESTIONS AND ANSWERS
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BMTCN EXAM QUESTIONS AND ANSWERS
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BMTCN EXAM QUESTIONS AND ANSWERSWhat type of transplants commonly have PTLD as a secondary malignancy? -
Answers- Allo HSCT with T-cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS - Answers-
alkylating agents (eg. Cytoxan, cisplatin, melphalan, busulfan, ifos) , radiation,
topoisomerase II inhibitors (eg. doxorubicin, etoposide, mitoxantrone)
Genetic predispositions that increase risk of primary and secondary cancers - Answers-
neurofibromatosis type 1, Fanconi anemia
Risk factors for PTLD - Answers- T-cell depleted graft, mismatched related or unrelated
donor.
Busulfan, ATG, mAbs, TBI
patient w/ primary immunodeficiency, acute or extensive GVHD, EBV
Risk factors for secondary solid tumors - Answers- younger age at HSCT, TBI, chronic
GVHD, increasing time from transplant, infections, genetic predisposition, lifestyle
factors
Treatment options for PTLD - Answers- EBV-specific cytotoxic T cells, mAbs targeted to
B cells (rituximab), combination chemotherapy
Treatment options for secondary MDS/acute leukemia - Answers- conventional chemo
or allo transplant. Poor outcomes.
QOL domains - Answers- Physical, Functional, Psychological, Social,
Spiritual/existential, Multiple interactions between domains
Altered sexual health in male HSCT survivors - Answers- damage to the hypothalamic-
pituitary-gonadal axis: elevated FSH, elevated LH, low testosterone levels; cavernosal
arterial insufficiency causing ED
Altered sexual health in female HSCT survivors - Answers- alkylating agents and
radiation cause infertility and premature ovarian failure, elevated FSH and LG, low
estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant - Answers- POF (premature ovarian
failure), TBI, chronic GVHD
Risk factors for infertility - Answers- pre-HSCT antineoplastic therapy, exposure to
alkylating agents, TBI or pelvic irradiation, older age
, Pregnancy risks in HSCT survivors - Answers- increased risk of preterm birth and low
birth weight, cardiac decompensation during pregnancy 2/2 prior anthracycline
exposure. Similar rate of spontaneous abortion to general population.
Recommended vaccines - Answers- Pneumococcal, Diptheria-tetanus, Pertussis,
Meningococcal, Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? - Answers- inactive vaccines start at 6 months
post HSCT, live vaccines start at 2 years post HSCT (in absence of ongoing
immunosuppression and GVHD)
Most common secondary malignancy in pediatric patients who received radiatios? -
Answers- Nonsquamous call carcinoma
Interventions/treatment for vaginal chronic GVHD - Answers- topical steroids, topical
cyclosporine, vaginal dilation
Prevention of vaginal chronic GVHD - Answers- patient education, topical estrogen,
early initiation of HRT, vaginal dilation in absence of sexual activity, regular gyn exams
Side effects of ovarian failure in prepubescent females - Answers- infertility, impaired
sexual development, short stature
Marker that shows immune recovery - Answers- CD4
Myeloid progenitor cell mature into: - Answers- Megakaryocytes (produce plts),
Erythrocytes, Mast cells, Myeloblasts, neutropils, basophils, macrophages, monocytes,
erythrocyte, eosinophils, myeloid dendritic cells, tissue mast cell
Lymphoid progenitor cells mature into: - Answers- NK cells, small lymphocytes, which
differentiate into B cells and T cells
innate immunity - Answers- occurs naturally, uses phagocytes that release
inflammatory mediators and NK cells
acquired immunity - Answers- response of either B cells or T cells to antigens
Syngeneic transplant - Answers- Identical twin source. No need for
immunosuppression. No graft-versus-tumor effect
Matched sibling/related transplant - Answers- HLA-identical relative. No potential stem
cell contamination. Continued access to cells. Only 25% of population has a sibling
match. Risk of GVHD.
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