Devita, Hellman, and Rosenberg's Cancer

LWBK1006-31 LWW-Govindan-Review December 12, 2011 19:43

Chapter 31•Acute Leukemias 441

Question 31.18. Three years later she presents to clinic with an elevated leukocyte count.

PCR of peripheral blood confirms the presence of her initialt(15;17)

translocation. Treatment options at this point include all of the following,

EXCEPT:

A. Arsenic trioxide

B. Gemtuzumab ozogamicin

C. Autologous transplant after achieving CR

D. Clofarabine

Question 31.19. A 30-year-old, otherwise healthy woman is diagnosed with AML. Cyto-

genetics reveal inv(16). She undergoes induction therapy. Day-14 bone

marrow biopsy shows an ablated marrow. Her day-45 marrow shows

restored cellularity without evidence of disease. Repeat cytogenetics do

not reveal the inv(16) rearrangement. Appropriate consolidation therapy

would be:

A. Allogeneic transplant if a matched sibling donor is available

B. High-dose cytarabine (HIDAC) 3 g/m^2 every 12 hours on days 1, 3,

and 5 for four 28-day cycles

C. Intermediate-dose cytarabine (IDAC) 300 mg/m^2 every 12 hours on

days 1, 3, and 5 for four 28-day cycles

D. Arsenic 0.15 mg/kg on days 1 to 5 for four 28-day cycles

Question 31.20. Which of the following regimens require graft-versus-tumor effects to

remove residual AML blasts?

A. Busulfan-cyclophosphamide

B. Cyclophosphamide-TBI

C. Busulfan-fludarabine

D. Busulfan-VP16

Question 31.21. High-dose busulfan used in myeloablative preparative regimens for stem

cell transplantation may result in all of the following side effects,

EXCEPT:

A. Seizures

B. Mucositis

C. Pancytopenia

D. MDS

Question 31.22. Central nervous system (CNS) prophylaxis should be considered in which

of the following patients?

A. A 25-year-old Latina woman with APL who presents with a WBC of

2500/L, an INR of 2.5, and fibrinogen of 100

B. A 78-year-old man with AML evolved from MDS

C. A 30-year-old woman with AML who develops headaches while

receiving ondansetron for nausea on day 9 of induction therapy

D. A 20-year-old man with Down syndrome and ALL who presents with

leukocytosis (WBC 120,000/L)