BMTCN
What type of transplants commonly have PTLD as a secondary malignancy? - Answer -Allo HSCT with T-
cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS - Answer -alkylating agents (eg.
Cytoxan, cisplatin, melphalan, busulfan, ifos) , radiation, topoisomerase II inhibitors (eg. doxorubicin,
etoposide, mitoxantrone)
Genetic predispositions that increase risk of primary and secondary cancers - Answer -neurofibromatosis
type 1, Fanconi anemia
Risk factors for PTLD - Answer -T-cell depleted graft, mismatched related or unrelated donor.
Busulfan, ATG, mAbs, TBI
patient w/ primary immunodeficiency, acute or extensive GVHD, EBV
Risk factors for secondary solid tumors - Answer -younger age at HSCT, TBI, chronic GVHD, increasing
time from transplant, infections, genetic predisposition, lifestyle factors
Treatment options for PTLD - Answer -EBV-specific cytotoxic T cells, mAbs targeted to B cells (rituximab),
combination chemotherapy
, Treatment options for secondary MDS/acute leukemia - Answer -conventional chemo or allo transplant.
Poor outcomes.
QOL domains - Answer -Physical, Functional, Psychological, Social, Spiritual/existential, Multiple
interactions between domains
Altered sexual health in male HSCT survivors - Answer -damage to the hypothalamic-pituitary-gonadal
axis: elevated FSH, elevated LH, low testosterone levels; cavernosal arterial insufficiency causing ED
Altered sexual health in female HSCT survivors - Answer -alkylating agents and radiation cause infertility
and premature ovarian failure, elevated FSH and LG, low estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant - Answer -POF (premature ovarian failure), TBI,
chronic GVHD
Risk factors for infertility - Answer -pre-HSCT antineoplastic therapy, exposure to alkylating agents, TBI
or pelvic irradiation, older age
Pregnancy risks in HSCT survivors - Answer -increased risk of preterm birth and low birth weight, cardiac
decompensation during pregnancy 2/2 prior anthracycline exposure. Similar rate of spontaneous
abortion to general population.
Recommended vaccines - Answer -Pneumococcal, Diptheria-tetanus, Pertussis, Meningococcal,
Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? - Answer -inactive vaccines start at 6 months post HSCT, live
vaccines start at 2 years post HSCT (in absence of ongoing immunosuppression and GVHD)
Most common secondary malignancy in pediatric patients who received radiatios? - Answer -
Nonsquamous call carcinoma
What type of transplants commonly have PTLD as a secondary malignancy? - Answer -Allo HSCT with T-
cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS - Answer -alkylating agents (eg.
Cytoxan, cisplatin, melphalan, busulfan, ifos) , radiation, topoisomerase II inhibitors (eg. doxorubicin,
etoposide, mitoxantrone)
Genetic predispositions that increase risk of primary and secondary cancers - Answer -neurofibromatosis
type 1, Fanconi anemia
Risk factors for PTLD - Answer -T-cell depleted graft, mismatched related or unrelated donor.
Busulfan, ATG, mAbs, TBI
patient w/ primary immunodeficiency, acute or extensive GVHD, EBV
Risk factors for secondary solid tumors - Answer -younger age at HSCT, TBI, chronic GVHD, increasing
time from transplant, infections, genetic predisposition, lifestyle factors
Treatment options for PTLD - Answer -EBV-specific cytotoxic T cells, mAbs targeted to B cells (rituximab),
combination chemotherapy
, Treatment options for secondary MDS/acute leukemia - Answer -conventional chemo or allo transplant.
Poor outcomes.
QOL domains - Answer -Physical, Functional, Psychological, Social, Spiritual/existential, Multiple
interactions between domains
Altered sexual health in male HSCT survivors - Answer -damage to the hypothalamic-pituitary-gonadal
axis: elevated FSH, elevated LH, low testosterone levels; cavernosal arterial insufficiency causing ED
Altered sexual health in female HSCT survivors - Answer -alkylating agents and radiation cause infertility
and premature ovarian failure, elevated FSH and LG, low estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant - Answer -POF (premature ovarian failure), TBI,
chronic GVHD
Risk factors for infertility - Answer -pre-HSCT antineoplastic therapy, exposure to alkylating agents, TBI
or pelvic irradiation, older age
Pregnancy risks in HSCT survivors - Answer -increased risk of preterm birth and low birth weight, cardiac
decompensation during pregnancy 2/2 prior anthracycline exposure. Similar rate of spontaneous
abortion to general population.
Recommended vaccines - Answer -Pneumococcal, Diptheria-tetanus, Pertussis, Meningococcal,
Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? - Answer -inactive vaccines start at 6 months post HSCT, live
vaccines start at 2 years post HSCT (in absence of ongoing immunosuppression and GVHD)
Most common secondary malignancy in pediatric patients who received radiatios? - Answer -
Nonsquamous call carcinoma
