Devita, Hellman, and Rosenberg's Cancer

LWBK1006-32 LWW-Govindan-Review November 24, 2011 11:28

450 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 32.4. Which of the following is TRUE concerning patients treated with ima-

tinib before allogeneic stem cell transplantation (ASCT) compared with

patients directly proceeding to ASCT in CML?

A. Treatment with imatinib during the chronic phase before transplan-

tation is associated with a worse overall survival after ASCT.

B. Treatment with imatinib before transplantation results in more organ

toxicity in the posttransplant setting.

C. Patients treated with imatinib before transplant have no difference in

overall survival or progression-free survival.

D. Patients with imatinib-resistance mutations display inferior overall

survival compared with cohorts with advanced stages of disease.

Question 32.5. A 34-year-old man was diagnosed with chronic-phase CML 3 years ago.

He was initially treated with imatinib and rapidly obtained a partial cyto-

genetic response. Unfortunately, the patient was noted to have developed

a relapse of disease. The patient has a human leukocyte antigen-matched

sibling, and the decision was made to undergo a myeloablative stem cell

transplant. Six months after transplantation, the patient is noted to have

developed evidence of BCR-ABL fusion by qualitative reverse transcrip-

tase polymerase chain reaction assessment. Which of the following is the

MOST appropriate initial course of action?

A. Continued observation because reemergence of the leukemic clone is

common up to 1 year after transplantation

B. Donor lymphocyte infusion

C. Retransplantation from an unrelated donor

D. Initiation of imatinib 400 mg daily

Question 32.6. Which of the following orally administered tyrosine kinase inhibitors is

indicated for the treatment of patients with newly diagnosed Ph+chronic-

phase CML?

A. Imatinib 400 mg daily

B. Dasatinib 100 mg daily

C. Nilotinib 300 mg twice daily

D. All of the above

Question 32.7. Which of the following is TRUE regarding chronic lymphocytic leukemia

(CLL)?

A. ZAP-70 overexpression is correlated with mutated VH genes.

B. Deletion 13q is the most common genetic aberration by fluorescence

in situ hybridization (FISH) in CLL.

C. 11q deletion is thought to be associated with Bcl-2 overexpression.

D. Patients with 17p deletions usually present with early-stage disease

that follows an indolent course.