Quiz: Thrombotic Microangiopathies in Multiple Myeloma

August 16, 2019
Bryant Furlow
Bryant Furlow

How much do you know about thrombotic microangiopathies in multiple myeloma? Here's your chance to find out.

In this quiz, you’ll get a chance to test your knowledge on thrombotic microangiopathies in multiple myeloma. Here’s your first question:

1.  Patients with multiple myeloma who develop thrombotic microangiopathies (TMAs) experience irreversible end-organ damage and high risk of death if treatment is delayed.

A.True

B.False

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Answer: A.True. TMAs are associated with both irreversible end-organ damage and high risk of mortality if treatment is delayed.

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2.  TMAs can include or involve which of the following?

A.Atypical hemolytic uremic syndrome (aHUS)

B.Thrombotic thrombocytopenic purpura (TTP)

C.Microangiopathic hemolytic anemia (MAHA)

D.All of the above

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Answer: D. All of the above. TMAs are a group of thrombocytopenic syndromes that involve MAHA and include TTP and aHUS.

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3.  TMAs can be triggered by which of the following antimyeloma therapies?

A. Chimeric antigen receptor T-cell (CAR-T)

B.Bone marrow transplantation

C.Total body irradiation

D.All of the above

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Answer: B. Bone marrow transplantation. Transplant-associated TMA can be triggered by BMT.

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4.  Major risk factors for transplant-associated TMA include which of the following?

A.Grade 3-4 acute graft-versus-host disease (GVHD)

B.No total body irradiation

C.Female sex

D.All of the above

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Answer: D. All of the above. Major risk factors for transplant-associated TMA include grade 3-4 acute GVHD, no total body irradiation, female sex, unrelated donor, and sirolimus, cyclosporine, or tacrolimus.

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5. Poor prognostic factors for patients with multiple myeloma and transplant-associated TMA include which of the following?

A.LDH/platelets ratio ≥ 20

B.Decreased serum C5b-C9 levels

C.Platelets > 20 x 109/L

D.All of the above

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A. LDH/platelets ratio ≥ 20. Poor prognostic factors for transplant-associated TMA include a TMA index (LDH/platelets ratio) of ≥ 20, platelets < 20 x 109/L, elevated serum C5b-C9 levels, hemoglobin < 8 g/dL, elevated serum creatinine, and proteinuria ≥ 30 mg/dL.

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