AOCNP REVIEW QUESTIONS AND
ANSWERS 100% CORRECT.
the risk for significant bone marrow suppression (8) - ANS -advanced age (>65),poor nutritional
status, preexisting autoimmune disease, DM, GI disorders, liver disease, or hematopoietic
disease, and substance abuse.
Cancer-induced bone marrow suppression (3) - ANS -a) dysfunctional hematopoietic cell within
the bone marrow, b) bone marrow infiltration with tumor c)general exhaustion of bone marrow
reserves
solid tumor malignancies with the highest propensity to infiltrate the bone marrow in the
course of metastasis - ANS -melanoma, cancer of the breast, lung, kidney and prostate
Nitrosoureas (Carmustine, Lomustine) - ANS -affect the pluripotent stem cell (affecting all cell
lines/cell cycle nonspecific agent) use for glioblastoma multiforme
severe myelosuppression may last up to 85 days, nadir of carmustine occurs in 26-60 days
Radiation induced bone marrow suppression occurs when (2) - ANS -1. treatment field involves
marrow producing tissue or with dose greater than 15 Gy
CD 4 counts < 500/mm3 - ANS -significant risk factor for oopotunisitic infections
Cyclosphosphamide - myelosuppression risk - ANS -moderate
Paclitaxel - myelosuppression risk - ANS -moderate
,Doxorubicin (Adriamycin) - myelosuppression risk - ANS -alkylating agnet, may produce severe
myelosuppression, the duration only about 21 days
Myelosupression secondary to radiation therapy peaks at - ANS -week 3
Suppression may occur in all cell lines simultaneously rather than sequentially as seen with
chemotherapy
The recovery period also may be less predictable.
Second malignancy : Acute leukemia - potential etiologic factor ? - ANS -Alkylating agent,
especially with high doses or cumulative doses of antimetabolites
Antitumor antibiotics
Corticosteroids
Epipodophyllotoxins (i.e Etoposide)
Second malignancy : Bladder cancer- potential etiologic factor ? - ANS -radiation therapy for
prostate cancer
Second malignancy : Brain tumors - potential etiologic factor ? - ANS -therapeutic radiation for
other cancer
Second malignancy : hepatoma- potential etiologic factor ? - ANS -Androgen therapy
Second malignancy : Kidney cancer - potential etiologic factor ? - ANS -Brain tumor therapies
Cisplatin, especially in treatment for testicular cancer
Second malignancy : Leukemia - potential etiologic factor ? - ANS -Antitumor antibiotics
, Brest cancer treatment
Lymphoma treatment
Post transplant immunosuppression
Prostate cancer treatment
Second malignancy : Lung cancer - potential etiologic factor ? - ANS -HIV infection
Theraputic radiation for other cancers
Second malignancy : Mesothelioma - potential etiologic factor ? - ANS -Thoracic radiation for
lung neoplasms
Second malignancy : Neuroectodermal tumors- potential etiologic factor ? - ANS -Growth
hormone replacement after children cancers
Theraputic radiation for other cancers
Second malignancy : Non-Hodgkin Lymphoma- potential etiologic factor ? - ANS -Alkylating
agent
Antimetabolites
Antitumor antibiotics
Cyclosporine
Radiation therapy
Tacrolimus
Cumulative radiation dose in excess of ___ Gy reporrted have more signifiant risk of secondary
malignancies - ANS -30 Gy
Second malignancy : Thyroid cancer- potential etiologic factor ? - ANS -Brain tumor therapies
ANSWERS 100% CORRECT.
the risk for significant bone marrow suppression (8) - ANS -advanced age (>65),poor nutritional
status, preexisting autoimmune disease, DM, GI disorders, liver disease, or hematopoietic
disease, and substance abuse.
Cancer-induced bone marrow suppression (3) - ANS -a) dysfunctional hematopoietic cell within
the bone marrow, b) bone marrow infiltration with tumor c)general exhaustion of bone marrow
reserves
solid tumor malignancies with the highest propensity to infiltrate the bone marrow in the
course of metastasis - ANS -melanoma, cancer of the breast, lung, kidney and prostate
Nitrosoureas (Carmustine, Lomustine) - ANS -affect the pluripotent stem cell (affecting all cell
lines/cell cycle nonspecific agent) use for glioblastoma multiforme
severe myelosuppression may last up to 85 days, nadir of carmustine occurs in 26-60 days
Radiation induced bone marrow suppression occurs when (2) - ANS -1. treatment field involves
marrow producing tissue or with dose greater than 15 Gy
CD 4 counts < 500/mm3 - ANS -significant risk factor for oopotunisitic infections
Cyclosphosphamide - myelosuppression risk - ANS -moderate
Paclitaxel - myelosuppression risk - ANS -moderate
,Doxorubicin (Adriamycin) - myelosuppression risk - ANS -alkylating agnet, may produce severe
myelosuppression, the duration only about 21 days
Myelosupression secondary to radiation therapy peaks at - ANS -week 3
Suppression may occur in all cell lines simultaneously rather than sequentially as seen with
chemotherapy
The recovery period also may be less predictable.
Second malignancy : Acute leukemia - potential etiologic factor ? - ANS -Alkylating agent,
especially with high doses or cumulative doses of antimetabolites
Antitumor antibiotics
Corticosteroids
Epipodophyllotoxins (i.e Etoposide)
Second malignancy : Bladder cancer- potential etiologic factor ? - ANS -radiation therapy for
prostate cancer
Second malignancy : Brain tumors - potential etiologic factor ? - ANS -therapeutic radiation for
other cancer
Second malignancy : hepatoma- potential etiologic factor ? - ANS -Androgen therapy
Second malignancy : Kidney cancer - potential etiologic factor ? - ANS -Brain tumor therapies
Cisplatin, especially in treatment for testicular cancer
Second malignancy : Leukemia - potential etiologic factor ? - ANS -Antitumor antibiotics
, Brest cancer treatment
Lymphoma treatment
Post transplant immunosuppression
Prostate cancer treatment
Second malignancy : Lung cancer - potential etiologic factor ? - ANS -HIV infection
Theraputic radiation for other cancers
Second malignancy : Mesothelioma - potential etiologic factor ? - ANS -Thoracic radiation for
lung neoplasms
Second malignancy : Neuroectodermal tumors- potential etiologic factor ? - ANS -Growth
hormone replacement after children cancers
Theraputic radiation for other cancers
Second malignancy : Non-Hodgkin Lymphoma- potential etiologic factor ? - ANS -Alkylating
agent
Antimetabolites
Antitumor antibiotics
Cyclosporine
Radiation therapy
Tacrolimus
Cumulative radiation dose in excess of ___ Gy reporrted have more signifiant risk of secondary
malignancies - ANS -30 Gy
Second malignancy : Thyroid cancer- potential etiologic factor ? - ANS -Brain tumor therapies
