BMTCN Certification Review Chapter 4 || with Complete Solution.
Goals of conditioning regimens correct answers -destroys residual disease
-immunosuppression to prevent graft rejection
-prepares bone marrow environment to accept donor cells
1st use of HSCT correct answers treatment for radiation exposure and atomic bomb accidents;
TBI was first conditioning regimen
1st transplant correct answers -1956 by Dr. E. Donnal Thomas
-between identical twins, one had leukemia
-used TBI for conditioning; did not provide long term disease control
1st conditioning chemo correct answers -cyclophosphamide with TBI with result of increase in
desease-free survival
high vs low dose TBI for conditioning correct answers no one dose superior; higher doses
associated with increase in transplant related mortality
myeloablative regimins consist of... correct answers lethal dose of chemo, usual 1 or more
alkylating agents w/ or w/out TBI followed by transplant
examples of myeloablative regimens: correct answers melphalan
BEAM
FluBu4
BuCy
MelTBI
CyTBI
TBI+Etop
, Cy+TBI+Etop
Reduced Intensity conditioning regimens correct answers -30% dose reduction --> lower toxicity
-causes prolonged cytopenias requiring stem cell infusions; does not fully irradicate bone
marrow
-mixed chimerism often observed
Role of T cells in gvhd and engraftment correct answers -maturity of T cell depends on source
-greater maturity = greater risk of GVHD
-The more T cells present, the less likely graft failure is to occur
conditioning regimens for MM and amyloidosis correct answers *Melphalan
-melphalan and TBI
-fludarabine and melphalan
-busulfan and cyclophophamide
conditioning regimens for lymphoma or AML correct answers Auto
*BEAM: carmustine, etoposide, cytarabine, melphalan
*Busulfan, etoposide, cyclophosphamide
-TBI, cyclophosphamide, etoposide
-thiotepa, busulfan, melphalan
-cyclophosphamide, carmustine, etoposide
-busulfan and cyclophosphamide
Goals of conditioning regimens correct answers -destroys residual disease
-immunosuppression to prevent graft rejection
-prepares bone marrow environment to accept donor cells
1st use of HSCT correct answers treatment for radiation exposure and atomic bomb accidents;
TBI was first conditioning regimen
1st transplant correct answers -1956 by Dr. E. Donnal Thomas
-between identical twins, one had leukemia
-used TBI for conditioning; did not provide long term disease control
1st conditioning chemo correct answers -cyclophosphamide with TBI with result of increase in
desease-free survival
high vs low dose TBI for conditioning correct answers no one dose superior; higher doses
associated with increase in transplant related mortality
myeloablative regimins consist of... correct answers lethal dose of chemo, usual 1 or more
alkylating agents w/ or w/out TBI followed by transplant
examples of myeloablative regimens: correct answers melphalan
BEAM
FluBu4
BuCy
MelTBI
CyTBI
TBI+Etop
, Cy+TBI+Etop
Reduced Intensity conditioning regimens correct answers -30% dose reduction --> lower toxicity
-causes prolonged cytopenias requiring stem cell infusions; does not fully irradicate bone
marrow
-mixed chimerism often observed
Role of T cells in gvhd and engraftment correct answers -maturity of T cell depends on source
-greater maturity = greater risk of GVHD
-The more T cells present, the less likely graft failure is to occur
conditioning regimens for MM and amyloidosis correct answers *Melphalan
-melphalan and TBI
-fludarabine and melphalan
-busulfan and cyclophophamide
conditioning regimens for lymphoma or AML correct answers Auto
*BEAM: carmustine, etoposide, cytarabine, melphalan
*Busulfan, etoposide, cyclophosphamide
-TBI, cyclophosphamide, etoposide
-thiotepa, busulfan, melphalan
-cyclophosphamide, carmustine, etoposide
-busulfan and cyclophosphamide
