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39 Cards in this Set
- Front
- Back
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During hematopoiesis, which cells leave bone marrow while still immmature?
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Lymphocytes
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When does nausea, vomiting start after chemotherapy?
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during day 1-3
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When does hair start to fall after chemotherapy?
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after a week
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When is the critical period you need to watch for fever and infection after chemotherapy is administered?
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day 10-18 when WBC reach the lowest level.
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How cessassion of hematopoesis affect immune function and blood clotting?
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- cellular immunity: decrease in phagocytic cells
- humoral immunity: unability to synthesize antibodies - platelet numbers fall: unable to stop bleeding after 1 week. - epithelial cell death(GI): ulceration - spermatogonia compromised |
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Cessation of hematopoiesis is lethal appproximately how many days after?
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7 days
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T/F: Drug combinations are more effective and less toxic than high dose of single drugs.
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T.
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What is the key concept of the intensity of chenotherapy?
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insufficient drug intensity is ineffective in inducing remission, excess can be leathal.
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What factors make up the intensity of chemotherapy?
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- intrinsic cytotoxicity
- individual dosage - drug dose rate under continuous infusion or repetitive administration - recovery period - number of different drugs |
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What is the induction combination of chemo for AML?
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AraC (cytosine arabinoside)
Daunorubicin or doxorubicin sometimes add thioguanine |
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How is CNS disease of AML treated?
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AraC and methotrexate
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Not careful antineoplastic drug delivery will cause what complications?
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skin necrosis results from drug extravasation
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How is antineoplastic drugs delivered?
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central line
* catheters in large vessel dilute the drugs under high blood flow and prevent local tissue damage. |
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What are the two ways to adminster intrathecal chemotherapy?
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1) inject drugs into Ommaya reservoir
2) inject drugs directly into CSF in the lower part of the spinal column. |
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Intrathecal chemotherapy is effective for ___.
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childhood leukemia
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What are some critical effects at the time of chemotherapy? and how to manage that?
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- immune suppression: prophylactic antibiotics
- thrombocytopenia: attention to bleeding |
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What are some delayed effects of chemotherapy?
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- secondary myelodysplasia
- testicular/ovarian damage |
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What is the major side effects of vincristine?
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peripheral neuropathy
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Which antineoplastic drug cause this side effects?
- peripheral neuropathy |
vincristine
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What is the major side effects of cyclophosphamide?
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hemorrhagic cystitis
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Which antineoplastic drug cause this side effects?
hemorrhagic cystitis |
cyclophosphamide
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What side effect does this drug cause?
Bleomycin |
pulmonary fibrosis
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What side effect does this drug cause?
Daunorubicin |
delayed congestive heart failure
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What side effect does this drug cause?
Methotrexate |
hepatic cirrhosis
brain injection toxicity |
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Which anti-neoplastic drug cause this side effect?
pulmonary fibrosis |
bleomycin
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Which anti-neoplastic drug cause this side effect?
delayed congestive heart failure |
daunorubicin
doxorubicin |
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Which anti-neoplastic drug cause this side effect?
hepatic cirrhosis brain injection toxicity |
methotrexate
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What are some common infections after chemo?
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- candida
- pyoderma - oral lesions, mucositis throughout GI - herpes zoster - pseudomonas |
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Describe the morphologic change in myocytes in Doxorubicin toxicity.
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- early changes(250mg): vacuolization
- advanced (500mg): loss of structure, vacuolization of SR. |
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Give 2 anti-neoplastic drugs that are mutagenic, clastogenic, and carcinogenic.
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- alkylating drugs: DNA crosslinking
- TOPOII inhibitors |
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T/F: All-cause mortality includes disease and treatment deaths.
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T.
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How to treat recurrent AML?
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- sometimes canbe re-induced with the same drug or different drugs
- bone marrow or peripheral stem cell transplantation |
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What experimental drug is useful for APL relapse?
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Tri-oxide
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How does stem cell transplantation benefit chemotherapy?
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- allow higher dose
- better restoration of normal cells |
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What technique is used to collect peripheral stem cells?
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aphoresis
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What are some ways of collecting stem cells?
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- aphoresis
- cord blood - bone marrow |
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What is the chemo drug combination for ALL?
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- glucocorticoids
- vincristine - asparaginase |
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Why is asparaginase effective for ALL?
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neoplastic cells lost ability to make asparagine, so they have to get it extracellularly. Decreasing the extracellular asparagine by asparaginase starve the neoplastic cells, cause death.
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Why is glucocorticoids useful in ALL, but not AML?
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for reasons unknown. It induce apoptosis only in lymphoid cells.
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