Blood Bank Quiz 2

What does HPC-A stand for and how is it collected

Hematopoietic progenitor cells collected by apheresis (leukocytapheresis)

What is the role of CD34+ marker in stem cell collection

used to identify and quantify hematopoietic stem cells in peripheral blood

What is the difference between HPC-A, HPC-M, and HPC-CB

HPC-A: mobilized stem cells collected by apheresis;
HPC-M: bone marrow-derived;
HPC-CB: cord blood-derived.

Which drugs are used to mobilize stem cells into peripheral blood

G-CSF (most common), GM-CSF (rare), chemotherapy (autologous only)

What are poor mobilizers, and why might they require bone marrow taps

patients whose marrow doesn’t release enough stem cells (e.g., post-chemo)

What is the rebound effect of myelotoxic chemotherapy on HPC counts

50-fold increase in HPCs 3–5 days post-neutropenic phase

During the neutropenic phase, what are the risks for patients

infection (low WBCs) and bleeding (low platelets)

How long is daily apheresis usually continued in allogenic donations

1-2 days

What are the common side effects of G-CSF and GM-CSF

bone pain, insomnia, headache, muscle pain, flu-like symptoms

What serious complications may occur in normal donors given growth factors

splenic rupture, severe thrombocytopenia, acute lung injury

Why is chemotherapy not used in allogenic donors

only growth factors are used to avoid unnecessary toxicity.

How long can HPC-M products be stored at room temperature

48–72 hrs at room temp

At what temperature should HPC-A products be stored if not infused immediately

2–8°C if > a few hours before infusion

What additional processing steps can be done to HPC-A products before infusion

Processing: plasma/RBC reduction, CD34+ selection, T-cell depletion, tumor purging

How are cryopreserved HPC-A units stored (mechanical vs liquid nitrogen)

Mechanical freezer: < –70°C; Liquid nitrogen: –196°C

How long can cryopreserved HPCs remain viable for trilineage engraftment

Viable for 15–24 years; supports trilineage engraftment (WBCs, platelets, RBCs)

How are HPC-A units thawed before infusion

37°C water bath or thaw + wash (reduces DMSO

What is the role of DMSO in cryopreservation, and what reactions can it cause

cryoprotectant; reactions include nausea, vomiting, headache, BP/pulse changes, cough

17. What type of bacterial contamination is most commonly seen in HPC infusions

CN staph

Define autologous, allogenic, and syngeneic HPC donation

Autologous = donor = recipient; Allogenic = donor ≠ recipient; Syngeneic = identical twin donor

Which donation types use chemotherapy plus growth factors, and which use growth factors only

Autologous uses chemo + growth factors; Allogenic/Syngeneic use growth factors only

When was the first umbilical cord blood transplant performed, and for what condition

1988; fanconi anemia (aplastic anemia that affects the BM’s ability to produce healthy cells)

What are the advantages of cord blood HPCs over marrow/peripheral blood HPCs?

More proliferative and self-renewal capacity

Why does cord blood transplantation have lower rates of GVHD?

naïve immune cells

When and where were the first UCB banks established?

New York (1992); also Dusseldorf, Milan, Paris

How are cord blood units collected after birth?

cord clamped/cut → umbilical vein puncture → collect blood

What changes have been made to cord blood processing compared to early methods?

volume & RBC reduction (sedimentation/centrifugation)

What preservative is used for cryopreservation of cord blood

10% DMSO in cryogenic bags

What is the approximate shelf life of properly frozen cord blood units

more than 15 years

Which four parties are involved in cord blood transplantation

Registry, UCB bank, Cell processing lab, Clinical team

How soon after thawing must cord blood units be infused

ASAP after thawing, final volume is 60-100 mL

What are colloids, and how are they prepared

Large molecules dispersed in a medium; NSA is from salvaged plasma, it is pooled, fractioned, and heated

What is the protein composition of colloids

NSA: 96% albumin, 4% globulins/protiens

What concentrations are colloids given in, and how should they be stored

25% or 5%; stored at 1–6°C; shelf life = 5 years

What is the function of Normal Serum Albumin (NSA)

Volume expander; eliminates HIV/HEP risk

What is Hydroxyethyl Starch (HES), and how is it used clinically

synthetic colloid used as a volume expander; IV solution used to prevent shock

What are crystalloids, and how do they differ from colloids?

aqueous solutions of mineral salts/water-soluble molecules; smaller than colloids

What is the concentration of sodium chloride in normal saline

0.9% NaCl

What is Ringer’s Lactate used for, and why is it considered a balanced solution

isotonic solution for large-volume replacement; balanced electrolytes

Which crystalloid is the only solution safe to transfuse with RBCs

Normal saline

For high-risk patients, what is more important: the type of fluid administered or the speed of administration?

Speed of fluid replacement

Where is erythropoietin naturally produced in the body

Kidneys

What is the function of EPO, and what must it be given with?

RBC production (erythropoiesis); must be given with iron

Name two clinical uses of EPO

anemia and to increase pre-op blood volume

What are two brand-name examples of EPO

Procrit, Epogen

List at least five strategies to reduce blood loss during surgery

avoid abdominal compression, use local anesthesia, maintain normothermia, hemodilution, induced hypotension, meticulous surgery, hemostatic agents, cell salvage

What is cell salvage, and how does it reduce transfusion needs

recovers patient’s own shed blood during surgery → cleans it → reinfuses back to patient.