MCQ MAHE 2000 Medicine Answer 21

1. Choice between
1. hydroxurea (preferred treatment once/day)
1. rapid onset (lower WBC in 1-2 days),
2. modest side effects (N&V, skin rash, oral mucosa ulcerations)
3. inhibits ribonucleoside reductase
2. a-Interferon
1. more side effects (myalgias, arthralgias, fevers)
2. modest survival advantage (can produce complete hematologic remissions (WBC <>
3. more expensive
4. 5% demonstrate complete cytogenic remissions (can’t detect BCR/ABL transcript)
3. Newest agent: TI-571
1. Pyamidine analog - directly inhibits the tyrosine kinase activity of BCR/ABL
2. In previously treated chronic phase patients, 50% complete remission rate
3. Non-treated had a 100% hematologic response
4. Bone Marrow Allograft
1. The one established curative therapy
2. Best with HLA matched sibling, but good with HLA-matched unrelated donors (graft vs. host dz in unrelated)
3. 10 year survival approx. 70%
2. Chronic phase treatment objectives:
1. control elevated WBC count
2. reduce symptoms of splenomegaly
3. treat metabolic complications

Category: MAHE 2000 MCQs