Question 1

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.
Umbilical cord stem cells:Are abundantly available.
Specimen collection poses no risk to mother and infant.
-Can be frozen.
-Have a low risk of viral contamination.
-Dos not have mature T cells, so risk of GVH is low.
-Generally have a low total number of stem cells for an adult transplant patient.
-Can reduce the GVL effect.
-Have only one unit available for each procedure.
Allogeneic stem cells:
Are adequate for transplant in adults.
-Provide multiple units available for each procedure.
-Compatibility testing is essential.
-Cryopreservation possible.

Question 2

Cord blood is a source of stem cells, but must meet certain requirements before being collected.Which of the following are factors 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 D

Question 3

A procedure used to decrease the potential for GVHD in an allogeneic transplant is:

Accepted Answer

A) Freeze thaw to kill lymphocytes. 
B) Activation of CD4 cells and suppression of CD8 cells. 
C) Purging of CD8 lymphocytes. 
D) Apheresis. 
A) Freeze thaw to kill lymphocytes. 
B) Activation of CD4 cells and suppression of CD8 cells. 
C) Purging of CD8 lymphocytes. 
D) Apheresis. C

Question 4

Which of the following best represents the proper order for drug regimen for a SCT patient?

Accepted Answer

A) Chemotherapy >antihistamine and antiemetic > GM-CSF 
B) Antihistamine and antiemetic > GM-CSF > chemotherapy 
C) Chemotherapy > GM-CSF > antihistamine and antiemetic 
D) GM-CSF > antihistamine and antiemetic > chemotherapy 
A) Chemotherapy >antihistamine and antiemetic > GM-CSF 
B) Antihistamine and antiemetic > GM-CSF > chemotherapy 
C) Chemotherapy > GM-CSF > antihistamine and antiemetic 
D) GM-CSF > antihistamine and antiemetic > chemotherapy

Question 5

Explain graft-versus-leukemia process in stem cell transplantation.

Accepted Answer

Graft-versus-leukemia is a positive cons

Question 6

What is the main reason for using an allogeneic stem cell transplant?

Accepted Answer

A) Cadaver cells are not suitable due to cytokine treatment of the patient. 
B) Adequate numbers are achieved with this type of transplantation. 
C) Highly incompatible tissues are found with the other types of transplantation. 
D) The disease process involves the patient's own stem cells preventing autologous transplant. 
A) Cadaver cells are not suitable due to cytokine treatment of the patient. 
B) Adequate numbers are achieved with this type of transplantation. 
C) Highly incompatible tissues are found with the other types of transplantation. 
D) The disease process involves the patient's own stem cells preventing autologous transplant.

Question 7

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

Accepted Answer

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

Question 8

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 9

Which of the following infectious agents has the ability to re-emerge in SCT patients on multiple occasions?

Accepted Answer

A) Streptococcus infection 
B) Cytomegalovirus infection 
C) Candidiasis 
D) Epstein-Barr virus infection 
A) Streptococcus infection 
B) Cytomegalovirus infection 
C) Candidiasis 
D) Epstein-Barr virus infection

Question 10

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 11

An optimum result of HLA compatibility is based on which of the following matches between the donor and recipient?

Accepted Answer

A) Class I and class II antigens 
B) HLA-A and HLA-B antigens 
C) HLA-DR, HLA-DP, and HLA-DQ 
D) HLA-A, HLA-B, and HLA-DR 
A) Class I and class II antigens 
B) HLA-A and HLA-B antigens 
C) HLA-DR, HLA-DP, and HLA-DQ 
D) HLA-A, HLA-B, and HLA-DR

Question 12

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 13

The most important antigens that need to be matched for a successful outcome in stem cell transplants are:

Accepted Answer

A) ABO. 
B) Rh. 
C) HLA. 
D) Ii. 
A) ABO. 
B) Rh. 
C) HLA. 
D) Ii.

Question 14

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 15

Which of the following infections can be life-threatening in a SCT patient during the peritransplant period?

Accepted Answer

A) Bacterial 
B) Fungal 
C) Viral 
D) All of the above 
A) Bacterial 
B) Fungal 
C) Viral 
D) All of the above

Question 16

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.

Question 17

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.

Question 18

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

Accepted Answer

A) Diagnosis of the patient 
B) Patient age 
C) Patient sex 
D) The weight of the patient 
A) Diagnosis of the patient 
B) Patient age 
C) Patient sex 
D) The weight of the patient

Question 19

Interpret the results below.A 64-year-old patient received a SCT in March.Two weeks after the transplant, the physician ordered a routine blood count.The patient's ANC is 12 x109/L and his platelet count is 65 x 109/L.Chimerism studies were performed six months after his transplant using VNTR polymorphisms, which indicated a partial chimerism.What does this 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 results are indeterminate in the long term. 
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 results are indeterminate in the long term. 
D) The patient did not achieve engraftment at all.

Question 20

This antigen can be used to identify stem cells by immunophenotyping:

Accepted Answer

A) CD34. 
B) CD4. 
C) CD8. 
D) CD33. 
A) CD34. 
B) CD4. 
C) CD8. 
D) CD33.

Exam 26: Hematopoietic Stem Cell Transplantation

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

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

A procedure used to decrease the potential for GVHD in an allogeneic transplant is:

Which of the following best represents the proper order for drug regimen for a SCT patient?

Explain graft-versus-leukemia process in stem cell transplantation.

What is the main reason for using an allogeneic stem cell transplant?

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

An early complication of a stem cell transplant includes:

Which of the following infectious agents has the ability to re-emerge in SCT patients on multiple occasions?

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

An optimum result of HLA compatibility is based on which of the following matches between the donor and recipient?

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

The most important antigens that need to be matched for a successful outcome in stem cell transplants are:

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

Which of the following infections can be life-threatening in a SCT patient during the peritransplant period?

Autologous stem cell transplant is commonly used as treatment for:

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

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

This antigen can be used to identify stem cells by immunophenotyping:

Introduction

Cellular Homeostasis

Hematopoiesis

Structure and Function of Hematopoietic Organs

The Erythrocyte

Hemoglobin

The Leukocyte

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopaties: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Granulocyte and Monocyte Disorders

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Disorders

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Acute Lymphoblastic Leukemias

Lymphoid Malignancies: Chronic Lymphoid Leukemias, Lymphomas, and Plasma Cell Neoplasms

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hematology Procedures and Hemostasis

Bone Marrow Examination

Automation in Hematology and Hemostasis

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Laboratory Testing in Coagulation

Quality Assessment in the Hematology Laboratory

Filters