BMTCN Review Chapter 7 - Survivorship Issues fully solved rated A+

BMTCN Review Chapter 7 - Survivorship IssuesSurvivors and Survivorship - correct answer An individual is considered a cancer survivor from the time of diagnosis through the balance of his/her life Survivorship is a distinct phase of the cancer experience Some patients do not embrace the term "cancer survivor" Some definitions acknowledge the impact of cancer survivorship on families, friends and caregivers HSCT Survivorship - correct answer Number is increasing -Improvements in outcomes -Expanding indications for transplant -Treatment of older patients with reduced-intensity conditioning Increased number of available donors Approximately 250,000 HSCT survivors are more than 5 years post-HSCT Pediatric HSCT survivors - correct answer Face unity challenges -Growth and development -Cognitive development -School re-entry Secondary Malignancies - correct answer Receiving chemotherapy associated with secondary malignancies -Auto HSCt survivors - 12 fold increased risk -Allo HSCT survivors - 3.5 fold increased risk Three distinct groups of secondary malignancies -MDS and AML -PTLD's -Second solid malignancies Therapy related MDS and AML - 5%-15% of auto HSCT -Usually within 2 - 5 years -Rare in the allo HSCT setting -Refer to page 202 for specifics Post auto HSCT t-MDS - poor prognosis. -Median survival 6 months Secondary Malignancies: Incidence - correct answer PTLD is the most common second malignancy in the first year after allo HSCT using a T-cell-depleted graft Survivors > 15 years post allo HSCT have a 3-fold risk of developing a solid malignancy compared to the general population Secondary Malignancies: Risk factors - PTLD - correct answer Characteristics of the graft Preparative regimen or agents for GVHD Primary immunodeficiency; acute or extensive cGVHD; or Epstein-Barr virus (EBV) Secondary Malignancies: Causes - correct answer Alkylating agents, topoisomerase inhibitors Radiation