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Chapter 98. Hematopoietic Stem Cell Transplantation

Which of the following statements is false regarding mobilization of peripheral blood progenitor cells (PBPCs) for autologous transplant?

A. The combination of chemotherapy with filgrastim enhances PBPC mobilization relative to filgrastim alone

B. Apheresis is continued daily until the target number of PBPCs per kilogram of the recipient’s weight is obtained

C. For adult recipients, the number of CD34+ cells does not correlate with time to engraftment

D. Lower yield of CD34+ cells is associated with administration of stem cell toxic drugs and intensive prior chemotherapy or radiotherapy

The donor may experience bone pain with growth factor injections Which of the following statements is true regarding the different graft sources for allogeneic transplant?

A. PBPC grafts contain less T and B cells than bone marrow grafts and therefore a decreased risk of graft-versus-host disease

B. A bone marrow graft is associated with quicker neutrophil and platelet engraftment

C. Umbilical cord blood transplants are limited by the inability to use donor-lymphocyte infusions in the event of relapse.

D. Adult patients are not eligible for umbilical cord blood transplants

E. T-cell-depleted grafts reduce the incidence of GVHD with similar incidence of graft failure and relapse

A 45-year-old woman who presents with non-Hodgkin lymphoma in second complete remission. You are explaining the rationale related to myeloablative preparative regimens for autologous hematopoietic stem cell transplantation (HSCT). Which of the following statements is true regarding the use of HSCT for this patient?

A. Myeloablative regimens result in mixed donor chimerism

B. The anti-lymphoma effect is mediated by high chemotherapy doses

C. The antilymphoma effect is mediated by high chemotherapy doses and a graft-versus-tumor (GVT) effect

D. Low chemotherapy doses are needed to ensure engraftment with subsequent GVT effects

E. High chemotherapy doses are needed for successful engraftment

When counseling a patient regarding potential toxicities of busulfan and fludarabine when used as a preparative regimen for HSCT, which of the following potential adverse effects should not be discussed?

A. Seizures

B. Nausea and vomiting

C. Sinusoidal obstructive syndrome (SOS)


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