Question 1

HSCs differ from committed progenitor cells by their:

Accepted Answer

A)  Ability to self-renew 
B)  Success in autologous transplantation 
C)  Potency in the immune response 
D)  Location of maturation 
A)  Ability to self-renew 
B)  Success in autologous transplantation 
C)  Potency in the immune response 
D)  Location of maturation A

Question 2

Which of the following is correct regarding allogeneic stem cell transplant and ABO antigens?

Accepted Answer

A)  ABO antigens do not need to be matched. 
B)  ABO antigens are strongly expressed on stem cells. 
C)  The O group patient should not receive stem cells from A or B blood group donors. 
D)  ABO antigens should always be matched between donor and recipient. 
A)  ABO antigens do not need to be matched. 
B)  ABO antigens are strongly expressed on stem cells. 
C)  The O group patient should not receive stem cells from A or B blood group donors. 
D)  ABO antigens should always be matched between donor and recipient. A

Question 3

A 64-year-old patient received an SCT in March. Two weeks after the transplant, the physician ordered a routine blood count. The patient's ANC is 12 × 109/L, and his platelet count is 65 × 109/L. Chimerism studies were performed 6 months after his transplant using VNTR polymorphisms, which indicated a partial chimerism. Interpret these results regarding what they mean for the patient.

Accepted Answer

A)  The patient achieved short-term and long-term engraftment. 
B)  The patient achieved long-term engraftment but not short-term engraftment. 
C)  The patient achieved short-term engraftment, but long-term results are indeterminate. 
D)  The patient did not achieve engraftment at all. 
A)  The patient achieved short-term and long-term engraftment. 
B)  The patient achieved long-term engraftment but not short-term engraftment. 
C)  The patient achieved short-term engraftment, but long-term results are indeterminate. 
D)  The patient did not achieve engraftment at all. C

Question 4

When calculating the dose of stem cells needed for the recipient, what factor per kilogram of recipient weight must be considered?

Accepted Answer

A)  When using umbilical cord blood, a minimum of 3.0 × 105 of total nucleated cells 
B)  Cell doses of a minimum of 2.5 - 5.0 × 106 CD34+ cells 
C)  Cell doses of a minimum of 0.5 - 5 × 103 CD56+ cells 
D)  When using umbilical cord blood, a minimum of 1.0 × 103 of total nucleated cells. 
A)  When using umbilical cord blood, a minimum of 3.0 × 105 of total nucleated cells 
B)  Cell doses of a minimum of 2.5 - 5.0 × 106 CD34+ cells 
C)  Cell doses of a minimum of 0.5 - 5 × 103 CD56+ cells 
D)  When using umbilical cord blood, a minimum of 1.0 × 103 of total nucleated cells.

Question 5

Which HSC quantitation method would be optimal for verification of late-stage engraftment?

Accepted Answer

A)  Manual count of MNCs 
B)  CD34 enumeration by flow cytometry 
C)  Cell culture for CFUs 
D)  Bone marrow exam for stem cells 
A)  Manual count of MNCs 
B)  CD34 enumeration by flow cytometry 
C)  Cell culture for CFUs 
D)  Bone marrow exam for stem cells

Question 6

An early complication of a stem cell transplant includes:

Accepted Answer

A)  Hypogonadism 
B)  Development of secondary leukemia 
C)  Graft-versus-host disease 
D)  Neuropathies 
A)  Hypogonadism 
B)  Development of secondary leukemia 
C)  Graft-versus-host disease 
D)  Neuropathies

Question 7

Following apheresis of a patient for an autologous stem cell transplant, the laboratician:

Accepted Answer

A)  Freezes the cells in bags with DMSO 
B)  Performs WBC, mononuclear cell, and CD34 cell count 
C)  Purges the sample of all T8 cells 
D)  Performs chimerism studies 
A)  Freezes the cells in bags with DMSO 
B)  Performs WBC, mononuclear cell, and CD34 cell count 
C)  Purges the sample of all T8 cells 
D)  Performs chimerism studies

Question 8

Graft-versus-host disease must have three factors. The first is the presence of immunocompetent donor T lymphocytes. What are the remaining two factors?

Accepted Answer

A)  Degree of marrow involvement and age of patient 
B)  Response to previous chemotherapy and underlying disease 
C)  HLA alloantigens and an immunosuppressed host 
D)  Donor availability and degree of marrow involvement 
A)  Degree of marrow involvement and age of patient 
B)  Response to previous chemotherapy and underlying disease 
C)  HLA alloantigens and an immunosuppressed host 
D)  Donor availability and degree of marrow involvement

Question 9

What is a primary disadvantage of transfusing umbilical cord blood as a source of HSCs?

Accepted Answer

A)  The risk of viral infection is high. 
B)  It needs to be frozen soon after collection. 
C)  Complications are associated with the collection. 
D)  The number of stem cells is usually insufficient for an adult transplant. 
A)  The risk of viral infection is high. 
B)  It needs to be frozen soon after collection. 
C)  Complications are associated with the collection. 
D)  The number of stem cells is usually insufficient for an adult transplant.

Question 10

Cord blood is a source of stem cells but must meet certain requirements before being collected. Which of the following is a factor that might lead to not collecting the cord blood?

Accepted Answer

A)  More than 50 mL being available 
B)  Nine-month gestation 
C)  Rh negative baby 
D)  Family history of inherited diseases 
A)  More than 50 mL being available 
B)  Nine-month gestation 
C)  Rh negative baby 
D)  Family history of inherited diseases

Question 11

Which of the following is used to quantitate the number of hematopoietic stem cells collected?

Accepted Answer

A)  CD34 quantitation by immunophenotyping 
B)  Chimerism study by immunophenotyping 
C)  Ratio of neutrophils to lymphocytes 
D)  Cytochemical study 
A)  CD34 quantitation by immunophenotyping 
B)  Chimerism study by immunophenotyping 
C)  Ratio of neutrophils to lymphocytes 
D)  Cytochemical study

Question 12

Which of the following occurs prior to infusion of stem cells into the recipient?

Accepted Answer

A)  Blood count for ANC 
B)  Chimerism studies 
C)  GM-CSF infusion 
D)  CD34 enumeration 
A)  Blood count for ANC 
B)  Chimerism studies 
C)  GM-CSF infusion 
D)  CD34 enumeration

Question 13

Graft-versus-host disease results from which of the following?

Accepted Answer

A)  Donor T cells initiating an immune response against host recipient cells 
B)  Secondary CMV infection 
C)  Recipient T cells initiating an immune response against donor cells 
D)  Tumor infiltration in MALT tissue 
A)  Donor T cells initiating an immune response against host recipient cells 
B)  Secondary CMV infection 
C)  Recipient T cells initiating an immune response against donor cells 
D)  Tumor infiltration in MALT tissue

Question 14

Explain the role of the laboratory professional in stem cell transplantation.

Accepted Answer

The role of the laboratory professional

Question 15

Compare and contrast the collection of umbilical cord stem cells for transplantation and that of allogeneic stem cells for transplantation.

Accepted Answer

Umbilical cord stem cell transplantation

Question 16

Which of the following determines the number of stem cells needed for a transplant procedure?

Accepted Answer

A)  Patient diagnosis 
B)  Patient age 
C)  Patient sex 
D)  Patient weight 
A)  Patient diagnosis 
B)  Patient age 
C)  Patient sex 
D)  Patient weight

Question 17

Which laboratory department is responsible for performing testing to verify short-term engraftment?

Accepted Answer

A)  Hematology 
B)  Molecular/HLA 
C)  Microbiology 
D)  Immunology 
A)  Hematology 
B)  Molecular/HLA 
C)  Microbiology 
D)  Immunology

Question 18

Which of the following laboratory tests is used to assess long-term engraftment?

Accepted Answer

A)  Automated complete blood count 
B)  Chimerism 
C)  CD34 count by flow 
D)  Manual WBC count 
A)  Automated complete blood count 
B)  Chimerism 
C)  CD34 count by flow 
D)  Manual WBC count

Question 19

What is the single most important factor considered in donor selection for an allogeneic transplant?

Accepted Answer

A)  HLA compatibility with the patient 
B)  ABO compatibility with the patient 
C)  CMV status of the donor 
D)  HLA and ABO compatibility with the recipient 
A)  HLA compatibility with the patient 
B)  ABO compatibility with the patient 
C)  CMV status of the donor 
D)  HLA and ABO compatibility with the recipient

Question 20

Autologous stem cell transplant is commonly used as treatment for:

Accepted Answer

A)  Hodgkin lymphoma 
B)  Acute myelogenous leukemia 
C)  Inherited diseases 
D)  Aplastic anemia 
A)  Hodgkin lymphoma 
B)  Acute myelogenous leukemia 
C)  Inherited diseases 
D)  Aplastic anemia

Exam 29: Hematopoietic Stem Cell Transplantation

HSCs differ from committed progenitor cells by their:

Which of the following is correct regarding allogeneic stem cell transplant and ABO antigens?

When calculating the dose of stem cells needed for the recipient, what factor per kilogram of recipient weight must be considered?

Which HSC quantitation method would be optimal for verification of late-stage engraftment?

An early complication of a stem cell transplant includes:

Following apheresis of a patient for an autologous stem cell transplant, the laboratician:

Graft-versus-host disease must have three factors. The first is the presence of immunocompetent donor T lymphocytes. What are the remaining two factors?

What is a primary disadvantage of transfusing umbilical cord blood as a source of HSCs?

Cord blood is a source of stem cells but must meet certain requirements before being collected. Which of the following is a factor that might lead to not collecting the cord blood?

Which of the following is used to quantitate the number of hematopoietic stem cells collected?

Which of the following occurs prior to infusion of stem cells into the recipient?

Graft-versus-host disease results from which of the following?

Explain the role of the laboratory professional in stem cell transplantation.

Compare and contrast the collection of umbilical cord stem cells for transplantation and that of allogeneic stem cells for transplantation.

Which of the following determines the number of stem cells needed for a transplant procedure?

Which laboratory department is responsible for performing testing to verify short-term engraftment?

Which of the following laboratory tests is used to assess long-term engraftment?

What is the single most important factor considered in donor selection for an allogeneic transplant?

Autologous stem cell transplant is commonly used as treatment for:

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

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