APHON Overview UPDATED ACTUAL
Exam Questions and CORRECT Answers
biotherapy - CORRECT ANSWER - modality of tx: agents that resemble body's own defense
and surveillance systems. can augment/modulate/restore host's immune response, direct
antitumor activity, other biological effects. side effects typically hypersensitivity rx
immune surveillance - CORRECT ANSWER - tumor cells express abnormal tumor antigens
on surface that can be recognized/destroyed by immune system
natural killer cells - CORRECT ANSWER - lymphocyte that recognizes/kills malignant cells
cytotoxic t cells - CORRECT ANSWER - recognize tumor-assosiated antigens and kills cells
interferons - CORRECT ANSWER - multiple moa's & produced w/ recombinant dna.
protein capable of protecting other cells from viral infections by interfering w/ viral replication.
family of glycoproteins include: antiviral, antiproliferative, potent immunomodulatory effects
cytokines - CORRECT ANSWER - products of immune cells to enhance cytotoxic activity of
cells and increase immune response
alpha-interferon - CORRECT ANSWER - leukocyte-derived. tx: hairy cell leukemia,
melanoma, chronic myeloid leukemia, follicular lymphoma, multiple myeloma, cutaneous t-cell
lymphoma
beta-interferon - CORRECT ANSWER - fibroblast-derived. tx MS
gamma-interferon - CORRECT ANSWER - t-lymphocyte derived. tx chronic granulomatus
disease
,interleukin-2 - CORRECT ANSWER - produced by t-helper cells & stimulate
growth/maturation of t-cell subsets, cytotoxic t-cells, production of lymphokines & cytokines.
act as chemical signals b/w wbc's (revs up immune system)
retinoids - CORRECT ANSWER - immunomodulators that facilitate differentiation &
suppress proliferation of cancer cells
all-trans retinoic acid (atra) - CORRECT ANSWER - tx: aml, aml m3 subtype, apl
increase maturation of promyelocytic blasts and rapid resolution of coagulopathy r/t tx.
isotretinoin (accutane) - CORRECT ANSWER - retinoid tx neuroblastoma.
have antitumor activity unknown moa. TERATOGENIC. male/female pt must register iPledge
(fetal exposure). can also affect hearing & vision
antibodies - CORRECT ANSWER - proteins produced by b-lymphocytes. part of humoral
immunity of adaptive system. includes immunoglobulins (igG, igA, igM, igE, igD)
murine - CORRECT ANSWER - mouse-derived MoAbs. pt develops human antimouse
antibodies creating high risk of hypersensitivity rx
end in -momab
Monoclonal antibodies - CORRECT ANSWER - very specific. directed against single
antigenic determinant on cell surface causing antibody-dependent cellular toxicity, direct cell
death, elimination of antigen/target cell that expresses the antigen
low toxicity
-ximab - CORRECT ANSWER - moab combo of human & mouse antibodies
-zumab - CORRECT ANSWER - moab humanized, small part of mouse antibody fused w/
human antibody
,-umab - CORRECT ANSWER - fully humanized moabs
chimeric moab - CORRECT ANSWER - murine variable & human constant coupled using
recombinant dna
purpose of moabs - CORRECT ANSWER - attach low-dose radioisotopes to image residual
disease. target chemo, radiation, biotherapy to tumor
purge autologous bone marrow of cancer cells before transplant
selectively remove t cells responsible for gvhd from marrow prior to allogenic transplant
efficacy increased w/ chemo or radioactive substances
rituximab - CORRECT ANSWER - tx relapsed/refractory b-cell lymphoma, cd20+, non-
hodgkins lymphoma (w/ chop), posttransplant lymphoproliferative d/o, & chronic gvhd
rituximab moa - CORRECT ANSWER - act on CD20 antigen on surface of normal/malignant
b lymphocytes and works w/ immune system to induce b-cell lysis
radiopharmaceuticals - CORRECT ANSWER - moabs that have radioactive source attached
for cancer killing effect
ibritumomab tiuxetan (zevalin) - CORRECT ANSWER - radiopharmaceutical tx
relapse/refractory low-grade follicular or transformed b-cell non-hodgkins lymphoma
rituximab + ibritumomab tiuxetan - CORRECT ANSWER - target cd20 protein on b-cells.
given prior to high dose of radiation. causes increased toxicity and severe infusion rx
tositumomab + iodine 131 tositumomab (bexxar) - CORRECT ANSWER - tx cd20+ follicular
non-hodgkin's lymphoma. moa: recognizes marker and signals immune response then radioactive
source locks on to moab, delivers radiation directly to cd20 marked cells and kills lymphoma b-
cells
, hematopoietic growth factors - CORRECT ANSWER - regulate different levels of
hematopoietic cascade. aka colony stimulating factors. primarily used for symptom management
& expedited recovery from chemo-induced bone marrow suppression
Colony Stimulating Factors - CORRECT ANSWER - ptns that support hematopoiesis.
decrease myelosuppression, accelerate recovery from bmt, tx infections/parasitic diseases, help
w/ pancytopenia
gcsf (filgrastim) - CORRECT ANSWER - stimulates neutrophil colonies to enhance
phagocytic activity and antibody-dependent killing tendency. starting dose 5 mcg/kg/day
neulasta (pegfilgrastim) - CORRECT ANSWER - long-acting gcsf. given 24h post chemo.
given once per chemo cycle. max dose is 6mg. kids <45kg dose is 0.1mg/kg
gm-csf (granulocyte macrophage csf; sargramostim) - CORRECT ANSWER - given post bmt
w/ non-hodgkins lymphoma, all, hodgkins disease. dose: 250 mcg/kg/day. typically iv over 2h
for 21 days. broader prod of neutrophil & monocyte colonies
epoetin alfa - CORRECT ANSWER - hormone produced naturally by kidneys in response to
decrease O2 levels. stimulates precursor cells in marrow to produce rbcs. dose 150 u/kg 3x/week
darbepoetin (aranesp) - CORRECT ANSWER - long-acting epoetin. given weekly. dose
0.45mcg/kg sq. titrate dosing to not get hgb >12
ESA APPRISE - CORRECT ANSWER - risk management system associated w/
erythropoiesis-stimulating factors. increase risk of tumor growth/progression, cv events,
decreased survival rates when hgb >12
oprelvekin (neumega) - CORRECT ANSWER - thrombopoietic growth factor. stim hsc &
megakaryocyte precursurs to pvt severe thrombocytopenia. dosing: qd sc @ 50mcg/kg 24h post
chemo until platelets >50k
Exam Questions and CORRECT Answers
biotherapy - CORRECT ANSWER - modality of tx: agents that resemble body's own defense
and surveillance systems. can augment/modulate/restore host's immune response, direct
antitumor activity, other biological effects. side effects typically hypersensitivity rx
immune surveillance - CORRECT ANSWER - tumor cells express abnormal tumor antigens
on surface that can be recognized/destroyed by immune system
natural killer cells - CORRECT ANSWER - lymphocyte that recognizes/kills malignant cells
cytotoxic t cells - CORRECT ANSWER - recognize tumor-assosiated antigens and kills cells
interferons - CORRECT ANSWER - multiple moa's & produced w/ recombinant dna.
protein capable of protecting other cells from viral infections by interfering w/ viral replication.
family of glycoproteins include: antiviral, antiproliferative, potent immunomodulatory effects
cytokines - CORRECT ANSWER - products of immune cells to enhance cytotoxic activity of
cells and increase immune response
alpha-interferon - CORRECT ANSWER - leukocyte-derived. tx: hairy cell leukemia,
melanoma, chronic myeloid leukemia, follicular lymphoma, multiple myeloma, cutaneous t-cell
lymphoma
beta-interferon - CORRECT ANSWER - fibroblast-derived. tx MS
gamma-interferon - CORRECT ANSWER - t-lymphocyte derived. tx chronic granulomatus
disease
,interleukin-2 - CORRECT ANSWER - produced by t-helper cells & stimulate
growth/maturation of t-cell subsets, cytotoxic t-cells, production of lymphokines & cytokines.
act as chemical signals b/w wbc's (revs up immune system)
retinoids - CORRECT ANSWER - immunomodulators that facilitate differentiation &
suppress proliferation of cancer cells
all-trans retinoic acid (atra) - CORRECT ANSWER - tx: aml, aml m3 subtype, apl
increase maturation of promyelocytic blasts and rapid resolution of coagulopathy r/t tx.
isotretinoin (accutane) - CORRECT ANSWER - retinoid tx neuroblastoma.
have antitumor activity unknown moa. TERATOGENIC. male/female pt must register iPledge
(fetal exposure). can also affect hearing & vision
antibodies - CORRECT ANSWER - proteins produced by b-lymphocytes. part of humoral
immunity of adaptive system. includes immunoglobulins (igG, igA, igM, igE, igD)
murine - CORRECT ANSWER - mouse-derived MoAbs. pt develops human antimouse
antibodies creating high risk of hypersensitivity rx
end in -momab
Monoclonal antibodies - CORRECT ANSWER - very specific. directed against single
antigenic determinant on cell surface causing antibody-dependent cellular toxicity, direct cell
death, elimination of antigen/target cell that expresses the antigen
low toxicity
-ximab - CORRECT ANSWER - moab combo of human & mouse antibodies
-zumab - CORRECT ANSWER - moab humanized, small part of mouse antibody fused w/
human antibody
,-umab - CORRECT ANSWER - fully humanized moabs
chimeric moab - CORRECT ANSWER - murine variable & human constant coupled using
recombinant dna
purpose of moabs - CORRECT ANSWER - attach low-dose radioisotopes to image residual
disease. target chemo, radiation, biotherapy to tumor
purge autologous bone marrow of cancer cells before transplant
selectively remove t cells responsible for gvhd from marrow prior to allogenic transplant
efficacy increased w/ chemo or radioactive substances
rituximab - CORRECT ANSWER - tx relapsed/refractory b-cell lymphoma, cd20+, non-
hodgkins lymphoma (w/ chop), posttransplant lymphoproliferative d/o, & chronic gvhd
rituximab moa - CORRECT ANSWER - act on CD20 antigen on surface of normal/malignant
b lymphocytes and works w/ immune system to induce b-cell lysis
radiopharmaceuticals - CORRECT ANSWER - moabs that have radioactive source attached
for cancer killing effect
ibritumomab tiuxetan (zevalin) - CORRECT ANSWER - radiopharmaceutical tx
relapse/refractory low-grade follicular or transformed b-cell non-hodgkins lymphoma
rituximab + ibritumomab tiuxetan - CORRECT ANSWER - target cd20 protein on b-cells.
given prior to high dose of radiation. causes increased toxicity and severe infusion rx
tositumomab + iodine 131 tositumomab (bexxar) - CORRECT ANSWER - tx cd20+ follicular
non-hodgkin's lymphoma. moa: recognizes marker and signals immune response then radioactive
source locks on to moab, delivers radiation directly to cd20 marked cells and kills lymphoma b-
cells
, hematopoietic growth factors - CORRECT ANSWER - regulate different levels of
hematopoietic cascade. aka colony stimulating factors. primarily used for symptom management
& expedited recovery from chemo-induced bone marrow suppression
Colony Stimulating Factors - CORRECT ANSWER - ptns that support hematopoiesis.
decrease myelosuppression, accelerate recovery from bmt, tx infections/parasitic diseases, help
w/ pancytopenia
gcsf (filgrastim) - CORRECT ANSWER - stimulates neutrophil colonies to enhance
phagocytic activity and antibody-dependent killing tendency. starting dose 5 mcg/kg/day
neulasta (pegfilgrastim) - CORRECT ANSWER - long-acting gcsf. given 24h post chemo.
given once per chemo cycle. max dose is 6mg. kids <45kg dose is 0.1mg/kg
gm-csf (granulocyte macrophage csf; sargramostim) - CORRECT ANSWER - given post bmt
w/ non-hodgkins lymphoma, all, hodgkins disease. dose: 250 mcg/kg/day. typically iv over 2h
for 21 days. broader prod of neutrophil & monocyte colonies
epoetin alfa - CORRECT ANSWER - hormone produced naturally by kidneys in response to
decrease O2 levels. stimulates precursor cells in marrow to produce rbcs. dose 150 u/kg 3x/week
darbepoetin (aranesp) - CORRECT ANSWER - long-acting epoetin. given weekly. dose
0.45mcg/kg sq. titrate dosing to not get hgb >12
ESA APPRISE - CORRECT ANSWER - risk management system associated w/
erythropoiesis-stimulating factors. increase risk of tumor growth/progression, cv events,
decreased survival rates when hgb >12
oprelvekin (neumega) - CORRECT ANSWER - thrombopoietic growth factor. stim hsc &
megakaryocyte precursurs to pvt severe thrombocytopenia. dosing: qd sc @ 50mcg/kg 24h post
chemo until platelets >50k
