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Chapter 98. Hematopoietic Stem Cell Transplantation

Student Questions

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

Answer: C

Option A: Incorrect. This statement is true. The combination of chemotherapy with an HGF enhances PBPC mobilization relative to HGF alone. In addition to treating the underlying malignancy, this approach lowers the risk of tumor cell contamination and the number of apheresis collections required, but there is a greater risk of adverse effects.

Option B: Incorrect. This statement is true; apheresis is continued daily until the target number of PBPCs per kilogram of the recipient's weight is obtained for a successful HSCT.

Option C: Correct. This statement is false as it has been documented that for adult recipients, the number of CD34+ cells correlates with time to engraftment.

Option D: Incorrect. This statement is true. Lower yield of CD34+ cells is associated with administration of stem cell toxic drugs and intensive prior chemotherapy or radiotherapy.

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

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

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

Answer: B

Option A: Incorrect. This statement is false. Allogeneic PBPC grafts contain approximately 10 times more T and B cells than bone marrow grafts and therefore an increased risk of GVHD.

Option B: Correct. This statement is true. The low cell dose in umbilical-cord grafts prohibit specific donor lymphocyte collection at time of graft procurement in addition to ethical considerations.

Option C: Incorrect. This statement is false. Compared with bone marrow, ...

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