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Chapter 95. Acute Leukemias

Student Questions

Which of the following combinations is the most useful in the maintenance phase of ALL?

A. Dexamethasone and asparaginase

B. Methotrexate and mercaptopurine

C. Vincristine and daunorubicin

D. Methotrexate and vincristine

Answer: B

Option A: Incorrect. These agents are used in the induction phase.

Option B: Correct. Mercaptopurine and methotrexate are the backbone of maintenance treatment.

Option C: Incorrect. Vincristin is given in the induction phase, and daunorubicin is used for induction in high risk patients.

Option D: Incorrect. Methotrexate is used in maintenance, but vincristine is used in induction.

Which of the following agents is most frequently used as prophylaxis for the prevention of Pneumocystis jiroveci pneumonia?

A. Amoxicillin

B. Cephalexin

C. Trimethoprim-sulfamethoxazole

D. Acyclovir

Answer: C

Option A: Incorrect. Amoxicillin is not used for PJP, but for otitis media.

Option B: Incorrect. Cephalexin is a first generation cephalosporin used to treat some skin infections.

Option C: Correct. Trimethoprim-sulfamethoxazole is the treatment of choice for PJP

Option D: Incorrect. Acyclovir is used for prophylaxis/treatment of herpes virus.

Which of the following is the most frequent side effect associated with cytarabine?

A. Cardiac toxicity

B. Hemorrhagic cystitis

C. Neurotoxicity

D. Hyperglycemia

Answer: C

Option A: Incorrect. Cardiac toxicity is the side effect associated with anthracyclines.

Option B: Incorrect. Hemorrhagic cystitis is the side effect associated with cyclophosphamide and ifosfamide.

Option C: Correct. Neurotoxicity is the main side effect associated with cytarabine.

Option D: Incorrect. Hyperglycemia is a side effect associated with asparaginase.

The single strongest prognostic factor in ALL is:

A. Age

B. Initial white count

C. Presence of central nervous system leukemia (CNS3)

D. Early treatment response as assessed by minimal residual disease (MRD) at end of induction

Answer: D

Option A: ...

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