HSCT

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Author:
alvo2234
ID:
252319
Filename:
HSCT
Updated:
2013-12-10 15:01:21
Tags:
Dr Saunders
Folders:
PT,IV,final
Description:
final
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  1. where can HSCs be obtained from
    • bone marrow 
    • peripheral blood
    • umbilical cord blood
  2. what is the time for engraftment for HSCs obtained from peripheral blood
    14 days
  3. what is the time of engraftment for HSCs obtain from bone marrow
    21 days
  4. what is the time to engrafment for HSCs from umbilical cord and placenta
    25 to 42 days
  5. rank (greatest to least) amt of HSCs needed to be collected
    • peripheral 
    • bone marrow
    • umbilical cord blood
  6. why is a cryoprotectant added to a stem cell bag
    to minimize damage during freezing
  7. what are the types of transplants
    • allogeneic; family/unrelated donor
    • autologous; self-donation
    • syngeneic; identical twin
  8. types of allogeneic donor
    • matched related donor
    • match unrelated donor---umbilical cord
    • haploidentical
  9. what are the advantages of receiving an autologous HSCT
    • engraftment
    • no graft vs host disease
  10. what are the disadvantages of receiving autologous HSCT?
    • highest risk of disease relapse
    • tumor contamination
    • no therapeutic graft vs. leukemia
  11. what is the chance of matching with siblings
    1/4
  12. the purpose of myeloblative chemo
    total ablation of the hosts bone marrow
  13. purpose of non-myeloablative chemo
    suppress hosts immune system
  14. when is prophylactic antibiotic, antifungal, antiviral tx started in HSCT patients
    on day -1
  15. when is immunosuppression started in allogeneic HSCT pts
    day -2
  16. drug class of busulfan
    AA
  17. drug class of fludarabine
    purine metabolite
  18. drug class of cyclophosphamide
    alkylating agent
  19. drug class of ifosfamide
    AA
  20. drug class of etoposide
    Topoisomerase Inhibitor
  21. drug class of rituximab
    MA
  22. drug class of melphalan
    AA
  23. drug class of carmustine
    AA
  24. drug class of cytarabine
    cytadine analog
  25. vincristine drug class
    vinca alkaloid
  26. drug class of doxorubicin
    antitumor abx
  27. drug class of clofarabine
    purine metabolite
  28. what regimen-related toxicities would be expected from carmustine, etoposide, cytarabine, melphalan
    • BMD (all)
    • pulmonary toxicities (carmustine)
    • CNS---ethanol intoxication (carmustine)
    • Hypotension (etoposide)
    • skin, eye (cyarabine)
    • GI (melphelan)
  29. risk factors for CINV
    • <50 yrs 
    • femal
    • hx of chronic alcohol use
    • hx of n/v during pregnancy or motion sickness
  30. high emetic %
    90 or more
  31. moderate emetic risk %
    30 - 90
  32. low emetic risk %
    10-30%
  33. minimal emetic risk %
    < 10
  34. high therapeutic emetic agents
    • 5-HT3 antagonists
    • NK-1 antagonists
    • corticosteroids
  35. things to consider for pts with breakthrough CINV
    • around the clock administration
    • fluid repletion
    • add different agents
  36. which agents can be added for breakthrough CINV
    • lorazepam
    • metoclopramide
    • dexamethasone
    • lorazepam+diphenhydramine+haloperidol
  37. AE of 5-HT3 antagonists
    • HA 
    • constipation
    • QTc prolongation
  38. AE of corticosteriods
    • insomnia
    • edema
    • wt gain
    • hyperglycemia
    • hypertension
    • dyspepsia
  39. AE of prochlorperazine, promethazine
    • constipation
    • hypotension
    • EPS
    • bradycardia (IV)
    • sedation
  40. AE of metoclopramide
    • sedation 
    • diarrhea
    • EPS
  41. metoclopramide is CI in which pts
    pts with GI obstruction
  42. agents used for high acute emetic risk
    • 5-HT3 antagonist
    • dexamethasone
  43. agents used for moderate - AC acute n/v
    • 5-HT3 ant
    • dexamethasone
  44. agents used for moderate acute n/v
    • palondasteron
    • dexamethasone
  45. agents used for low acute n/v
    • single agent:
    • dex
    • 5-HT3
    • DRA
  46. agents used for high/moderate delayed n/v
    dex
  47. emetogenicity of busulfan
    moderate
  48. emetogenicity of cyclophosphamide
    • high >1500
    • moderate < 1500
  49. emetogenicity of ifosfamide
    • high >2 
    • moderate <2
  50. emetogenicity of melphalan
    moderate
  51. emetogenticity of carmustine
    • high >250
    • moderate <250
  52. emetogenicity of etoposide
    low
  53. emetogenicity of rituximab
    minimal
  54. emetogenicity of vincristine
    minimal
  55. emetogenicity of fludarabine
    minimal
  56. emetogen of clofarabine
    moderate
  57. emetogen of cytarabine
    • mod > 2000
    • low 100-200
  58. emetogen of doxorubicin
    • high >60
    • mod <60
  59. chemotherapeutic agents commonly causing mucositis
    • busulfan
    • etoposide
    • melphalan
    • mtx
  60. tx for mucositis
    • ice 
    • oral rinse
    • pain control
  61. tx for diarrhea
    • loperamide
    • diphenoxylate/atropine
    • octreotide
    • tincture of opium
  62. which antimotility agent is given IV
    octreotide

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