Devita, Hellman, and Rosenberg's Cancer

LWBK1006-42 LWW-Govindan-Review December 12, 2011 20:38

Chapter 42•Stem Cell Transplantation 527

Question 42.10. VOD of the liver is associated with which of the following factors:

A. Presence of acute GVHD

B. Oral busulfan conditioning

C. Advanced age

D. All of the above

Question 42.11. All of the following are part of the clinical syndrome of VOD, EXCEPT:

A. Jaundice

B. Tender hepatomegaly

C. Weight gain and ascites

D. Diarrhea

Question 42.12. A 50-year-old man presents to the hospital with shortness of breath and

fevers 2 months after an unrelated donor HSCT for AML (M5). He is

found to be hypoxic on presentation. Chest radiography shows diffuse

pulmonary infiltrates. He is placed on broad-spectrum antibiotics and has

been compliant with antifungal and anti-Pneumocystis jiroveciipneumo-

nia prophylaxis since his transplant. Sputum culture is negative. Periph-

eral blood cytomegalovirus (CMV) polymerase chain reaction (PCR)

shows an unquantifiable number of viral DNA copies. A bronchoscopy is

performed with lavage showing bloody secretions with negative aerobic,

anaerobic, fungal, and viral cultures. Bronchoalveolar lavage is tested for

galactomannan, which is negative, and the tumor necrosis factor-level

is found to be elevated. His condition fails to improve with antibiotics.

What is the most likely diagnosis?

A. CMV pneumonitis

B. Idiopathic pneumonitis

C. Pneumocystis pneumonia

D. Relapsed leukemia

Question 42.13. All of the following are risk factors for developing acute GVHD post-

transplant, EXCEPT:

A. T-cell replete graft

B. Mismatch at HLA-DP

C. Older age of recipient

D. Unrelated donor

Question 42.14. Each of the following is appropriate as infection prophylaxis in a patient

with chronic GVHD on corticosteroids, EXCEPT:

A. Dapsone

B. Fluconazole

C. Penicillin VK

D. Ganciclovir