BMTCN
What type of transplants commonly have PTLD as a secondary malignancy? correct answerAllo HSCT
with T-cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS correct answeralkylating 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 correct
answerneurofibromatosis type 1, Fanconi anemia
Risk factors for PTLD correct answerT-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 correct answeryounger age at HSCT, TBI, chronic GVHD,
increasing time from transplant, infections, genetic predisposition, lifestyle factors
Treatment options for PTLD correct answerEBV-specific cytotoxic T cells, mAbs targeted to B cells
(rituximab), combination chemotherapy
Treatment options for secondary MDS/acute leukemia correct answerconventional chemo or allo
transplant. Poor outcomes.
QOL domains correct answerPhysical, Functional, Psychological, Social, Spiritual/existential, Multiple
interactions between domains
Altered sexual health in male HSCT survivors correct answerdamage 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 correct answeralkylating agents and radiation cause
infertility and premature ovarian failure, elevated FSH and LG, low estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant correct answerPOF (premature ovarian failure), TBI,
chronic GVHD
Risk factors for infertility correct answerpre-HSCT antineoplastic therapy, exposure to alkylating agents,
TBI or pelvic irradiation, older age
Pregnancy risks in HSCT survivors correct answerincreased 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 correct answerPneumococcal, Diptheria-tetanus, Pertussis, Meningococcal,
Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? correct answerinactive 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? correct
answerNonsquamous call carcinoma
Interventions/treatment for vaginal chronic GVHD correct answertopical steroids, topical cyclosporine,
vaginal dilation
Prevention of vaginal chronic GVHD correct answerpatient education, topical estrogen, early initiation of
HRT, vaginal dilation in absence of sexual activity, regular gyn exams
Side effects of ovarian failure in prepubescent females correct answerinfertility, impaired sexual
development, short stature
What type of transplants commonly have PTLD as a secondary malignancy? correct answerAllo HSCT
with T-cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS correct answeralkylating 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 correct
answerneurofibromatosis type 1, Fanconi anemia
Risk factors for PTLD correct answerT-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 correct answeryounger age at HSCT, TBI, chronic GVHD,
increasing time from transplant, infections, genetic predisposition, lifestyle factors
Treatment options for PTLD correct answerEBV-specific cytotoxic T cells, mAbs targeted to B cells
(rituximab), combination chemotherapy
Treatment options for secondary MDS/acute leukemia correct answerconventional chemo or allo
transplant. Poor outcomes.
QOL domains correct answerPhysical, Functional, Psychological, Social, Spiritual/existential, Multiple
interactions between domains
Altered sexual health in male HSCT survivors correct answerdamage 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 correct answeralkylating agents and radiation cause
infertility and premature ovarian failure, elevated FSH and LG, low estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant correct answerPOF (premature ovarian failure), TBI,
chronic GVHD
Risk factors for infertility correct answerpre-HSCT antineoplastic therapy, exposure to alkylating agents,
TBI or pelvic irradiation, older age
Pregnancy risks in HSCT survivors correct answerincreased 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 correct answerPneumococcal, Diptheria-tetanus, Pertussis, Meningococcal,
Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? correct answerinactive 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? correct
answerNonsquamous call carcinoma
Interventions/treatment for vaginal chronic GVHD correct answertopical steroids, topical cyclosporine,
vaginal dilation
Prevention of vaginal chronic GVHD correct answerpatient education, topical estrogen, early initiation of
HRT, vaginal dilation in absence of sexual activity, regular gyn exams
Side effects of ovarian failure in prepubescent females correct answerinfertility, impaired sexual
development, short stature
