BMTCN Exam Questions & Answers 2023/2024
What type of transplants commonly have PTLD as a secondary malignancy? - ANSWER-Allo HSCT with T-
cell depleted graft
Therapies associated with therapy-related acute leukemia and MDS - ANSWER-alkylating 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 - ANSWER-
neurofibromatosis type 1, Fanconi anemia
Risk factors for PTLD - ANSWER-T-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 - ANSWER-younger age at HSCT, TBI, chronic GVHD, increasing time from transplant, infections, genetic predisposition, lifestyle factors
Treatment options for PTLD - ANSWER-EBV-specific cytotoxic T cells, mAbs targeted to B cells (rituximab),
combination chemotherapy
Treatment options for secondary MDS/acute leukemia - ANSWER-conventional chemo or allo transplant. Poor outcomes.
QOL domains - ANSWER-Physical, Functional, Psychological, Social, Spiritual/existential, Multiple interactions between domains Altered sexual health in male HSCT survivors - ANSWER-damage 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 - ANSWER-alkylating agents and radiation cause infertility and premature ovarian failure, elevated FSH and LG, low estradiol, menopausal symptoms
Risk factors for vaginal alterations post transplant - ANSWER-POF (premature ovarian failure), TBI, chronic GVHD
Risk factors for infertility - ANSWER-pre-HSCT antineoplastic therapy, exposure to alkylating agents, TBI or pelvic irradiation, older age
Pregnancy risks in HSCT survivors - ANSWER-increased 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 - ANSWER-Pneumococcal, Diptheria-tetanus, Pertussis, Meningococcal, Inactivated polio
Hep B, Recombinant Hep A, Influenza, Measles Mumps and Rubells, HPV
When can HSCT survivors get vaccines? - ANSWER-inactive 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? - ANSWER-
Nonsquamous call carcinoma
Interventions/treatment for vaginal chronic GVHD - ANSWER-topical steroids, topical cyclosporine, vaginal dilation
Prevention of vaginal chronic GVHD - ANSWER-patient education, topical estrogen, early initiation of HRT, vaginal dilation in absence of sexual activity, regular gyn exams
