Deck 19: Cellular Therapy in the Transplant Setting

Question 1

HPC-A collections are performed:

A) using a needle to access the marrow space of the posterior iliac crest.
B) employing apheresis technology.
C) with an automated device to process blood and collect peripheral blood.
D) by all of these methods.

Answer 1

C

Question 2

What is the first cell in the formation of all blood cells?

A) Hematopoietic stem cell
B) Hematopoietic progenitor cell
C) Multipotent progenitor cell
D) Pluripotent progenitor cell

Answer 2

A

Question 3

Which of these infectious diseases is not included in screening tests for donors of allogeneic HPC products?

A) cytomegalovirus (CMV)
B) human T-cell lymphotrophic virus (HTLV)
C) respiratory syncytial virus (RSV)
D) syphilis

Answer 3

C

Question 4

The myeloid line of hematopoietic progenitor cells (HPC-M) includes all but which of the following?

A) Erythrocytes
B) Monocytes
C) Dendritic cells
D) Basophils

Question 5

Hematopoietic progenitor cell transplantation has been used to treat which of the following diseases?

A) Adrenoleukodystrophy
B) Aplastic anemia
C) Lysosomal disorders
D) All of the above

Question 6

Donors of allogeneic HPC products have to be carefully screened for which of these?

A) Sickle cell disease
B) Human leukocyte antigen (HLA) type
C) Congenital immune deficiencies
D) All of these

Question 7

What cells are produced as a result of hematopoiesis?

A) Red blood cells
B) Platelets
C) White blood cells
D) All of these

Question 8

Donors of autologous HPC products have to be carefully screened for which of these?

A) Congenital immune deficiencies
B) Human leukocyte antigen (HLA) type
C) Infectious diseases
D) Sickle cell disease

Question 9

An identical twin donating to his or her twin sibling is an example of what kind of hematopoietic progenitor cell donation?

A) Autologous
B) Syngeneic
C) Allogeneic
D) Philogeneic
E)

Question 10

Autologous HPC donation is used to treat all of the following EXCEPT:

A) Lymphoproliferative
B) Malignant myeloproliferative processes
C) Plasma cell disorders
D) Solid tumors

Question 11

Bone marrow transplants and peripheral blood stem cell transplantation (PBSCT) are most commonly used in the treatment of which of the following diseases?

A) Lymphoma
B) Multiple myeloma
C) Neuroblastoma
D) All of the above

Question 12

The use of one's own HPCs for transplantation is referred to as:

A) Allogeneic
B) Autologous
C) Syngeneic
D) None of these

Question 13

Which of these infectious diseases is not included in screening tests for donors of allogeneic HPC products?

A) Hepatitis B virus (HBV)
B) Hepatitis C virus (HCV)
C) Human immunodeficiency virus (HIV)
D) Human papilloma virus (HPV)
E)

Question 14

What term is used if an HPC donor is an identical twin?

A) Allogeneic
B) Autologous
C) Syngeneic
D) None of these

Question 15

Which of the following is a cytokine used to stimulate hematopoietic progenitor cell production for harvest by apheresis?

A) Filgrastrim
B) Naproxen
C) Progesterone
D) Erythropoietin

Question 16

Which protein surface marker is used to assess the concentration of HPCs?

A) CD 16
B) CD 34
C) FMC-7
D) HLA-DR

Question 17

Donor screening for HPC products includes:

A) a physical examination.
B) completion of screening questionnaire.
C) review of relevant medical records.
D) all of these.

Question 18

Allogeneic HPC donation is commonly used to treat which of the following?

A) Lymphoproliferative
B) Malignant myeloproliferative processes
C) Plasma cell disorders
D) Solid tumors

Question 19

HPC-M collections are performed:

A) using a needle to access the marrow space of the posterior iliac crest.
B) employing apheresis technology.
C) with an automated device to process blood and collect peripheral blood.
D) by all of these methods.

Question 20

HPC transplantation using HPCs from another individual is referred to as:

A) Allogeneic
B) Autologous
C) Syngeneic
D) None of these

Question 21

What percent of HPC transplants have a bidirectional ABO incompatibility?

A) 1% to 5 %
B) 6% to 14 %
C) 15% to 19 %
D) 20% to 25 %

Question 22

HPC products are typically manipulated to reduce the total number of contaminating red blood cells (RBCs) for recipients with which ABO incompatibility?

A) Bidirectional
B) Major
C) Minor
D) All of these

Question 23

What is the purpose of recipient conditioning?

A) Destroys tumor cells
B) Creates a niche for donor HPC to occupy
C) Ensures engraftment of allogeneic product
D) All of these

Question 24

Myeloablative conditioning means

A) intervention uses reduced amounts of chemotherapy and/or radiation.
B) without intervention the bone marrow would not recover without HPC transplantation.
C) without intervention immune function is able to recover without HPC transplantation.
D) none of these.

Question 25

The final bacterial culture was positive for hematopoietic progenitor cell batch. What must be done with this batch?

A) The batch must be discarded.
B) Broad spectrum antibiotics can be given to the patient and the batch infused.
C) Have a sensitivity done on the culture and administer the batch, as well as provide antibiotics to which the bacteria are sensitive to the patient.
D) The batch can be irradiated and then transfused.

Question 26

What is the target collection goal for CD34 positive cells in an HPC product?

A) 1 × 106 to 2 × 106 CD34 positive cells per kilogram of recipient body weight
B) 2 × 106 to 6 × 106 CD34 positive cells per kilogram of recipient body weight
C) 6 × 106 to 10 × 106 CD34 positive cells per kilogram of recipient body weight
D) 10 × 106 to 15 × 106 CD34 positive cells per kilogram of recipient body weight

Question 27

What percent of HPC transplants have major ABO incompatibility?

A) 1% to 5 %
B) 6% to 14 %
C) 15% to 19 %
E) 20% to 25 %

Question 28

HPC transplant recipients can be at risk for delayed red blood cell production in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) none of these

Question 29

Nonmyeloablative conditioning means:

A) intervention uses reduced amounts of chemotherapy and/or radiation.
B) without intervention the bone marrow would not recover without HPC transplantation.
C) without intervention immune function would not recover without HPC transplantation.
D) none of these.

Question 30

Dimethyl sulfoxide (DMSO) is used to wash HPC product in order to remove which cells?

A) Progenitor cells
B) Red blood cells
C) White blood cells
D) None of these.

Question 31

What concentration of dimethyl sulfoxide (DMSO) is used to wash HPC product?

A) 1%
B) 2%
C) 5%
D) 10%

Question 32

What percent of HPC transplants have a minor ABO incompatibility?

A) 1% to 5 %
B) 6% to 14 %
C) 15% to 19 %
D) 20% to 25 %

Question 33

Plasma content of HPC products is reduced for recipients with which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) All of these

Question 34

When not all of the recipient's hematopoietic progenitor cells are destroyed prior to transplantation, it is called:

A) myeloablative conditioning.
B) nonmyeloablative conditioning.
C) syngeneic conditioning.
D) xerographic conditioning.

Question 35

Laboratory tests performed on HPC products include the enumeration of all of these EXCEPT:

A) Plasma cells
B) Progenitors
C) Viable cells
D) WBC percentages

Question 36

HPC transplant recipients can be at risk for delayed platelet production in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 37

HPC transplant recipients can be at risk for delayed granulocyte production in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 38

What is involved in the cryopreservation of HPCs?

A) addition of a cryoprotectant to the HPC product
B) freezing in a controlled-rate freezer
C) long-term storage in a liquid nitrogen freezer
D) All of these

Question 39

What is the target collection goal for CD34 positive cells in an HPC products?

A) CD34 enumeration
B) Complete blood count
C) White blood cell differential
D) All of these

Question 40

Which of the following statements about dimethyl sulfoxide (DMSO) is true?

A) DMSO is nontoxic.
B) DMSO prevents damage to HPCs during the freezing process.
C) DMSO destroys non-HPC white blood cells.
D) All of the above

Question 41

HPC transplant recipients require significant blood product support because they:

A) often have a period of hypoproliferative cytopenia.
B) are experiencing complications of refractoriness.
C) either of these
D) neither or these

Question 42

Donor plasma antibodies can bind to and cause destruction of recipient RBCs in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 43

Both autologous and allogeneic HPC transplant recipients are at an increased risk for which type of graft-versus-host disease?

A) Acute
B) Chronic
C) Transfusion-associated
D) None of these

Question 44

Transfused lymphocytes escape detection and are able to divide and harm the recipient's tissues, resulting in which type of graft-versus-host disease?

A) Acute
B) Chronic
C) Transfusion-associated
D) None of these

Question 45

Which of these conditions may develop in HPC transplant recipients?

A) ABO incompatibility complications
B) Passenger lymphocyte syndrome
C) Platelet refractoriness
D) All of these

Question 46

Which symptom is NOT likely to have been caused by chronic GVHD?

A) Dry mouth
B) Gastroenteritis
C) Joint contractures
D) Lung damage

Question 47

Delayed hemolysis of recipient RBCs due to passenger lymphocyte syndrome can be seen in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 48

For a recipients with a major mismatch, HPC products of which group are usually selected until the recipient antibodies that are incompatible with HPC product are no longer detected?

A) O
B) A
C) B
D) AB

Question 49

Which of the following statement concerning graft-versus-host disease (GVHD) is TRUE?

A) GVHD can be avoided by using leuko-reduced HPC product.
B) GVHD is a nonimmune-mediated disease.
C) GVHD results from a failure of the autologous HPC to engraft.
D) GVHD results from mismatches in HLA types between the donor and recipient.

Question 50

Which symptom is NOT likely to have been caused by acute GVHD?

A) Gastroenteritis
B) Reduced mobility
C) Skin rash
D) Transaminitis

Question 51

Which type of graft-versus-host disease results if contaminating donor lymphocytes are not recognized and destroyed by the recipient's immune system?

A) Acute
B) Chronic
C) Transfusion-associated
D) All of these

Question 52

Which incompatibility complication is most common in HPC transplant recipients?

A) ABO
B) HLA
C) Rh
D) None of these

Question 53

Which of these techniques best helps to reduce infections with cytomegalovirus?

A) Collection from CMV seronegative donors
B) Leukoreduction
C) A combination of both of these
D) Neither of these can reduce CMV.

Question 54

Which type of graft-versus-host disease is usually fatal?

A) Acute
B) Chronic
C) Transfusion-associated
D) All of these

Question 55

Minor hemolysis of recipient RBCs due to passenger lymphocyte syndrome can be seen in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 56

A transplant recipient has developed pancytopenia, with an elevation in liver enzymes and is experiencing bouts of diarrhea. This patient has most likely developed which form of GVHD?

A) Acute
B) Chronic
C) Transfusion-associated
D) None of these

Question 57

Reduction of TA-GVHD risk is accomplished through all of the following EXCEPT:

A) damaging donor lymphocyte DNA.
B) irradiation of blood products.
C) leukocyte reduction
D) pathogen-reduction techniques.

Question 58

Acute hemolysis of recipient RBCs may occur by ABO-incompatible antibodies in the recipient that lyse donor red blood, in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 59

Acute hemolysis of recipient RBCs may occur by ABO-incompatible antibodies in the transplant product, in which ABO incompatibility?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) None of these

Question 60

What is the overall incidence of graft-versus-host disease?

A) 0% to 10%
B) 10% to 30 %
C) 30% to 50 %
D) 60% to 80 %

Question 61

For recipients with a bidirectional incompatibility, HPC products of which group are usually selected until the recipient antibodies that are incompatible with HPC product are no longer detected?

A) O
B) A
C) B
D) AB

Question 62

Group O hematopoietic progenitor cell products are best used for which type of mismatch situation?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) All of these

Question 63

For recipients with a minor mismatch, HPC products of which group are usually selected until the recipient antibodies that are incompatible with HPC product are no longer detected?

A) O
B) A
C) B
D) AB

Question 64

Group AB plasma is best used for which type of mismatch situation?

A) Bidirectional ABO incompatibility
B) Major ABO incompatibility
C) Minor ABO incompatibility
D) All of these