Chapter 21, Problem 4CCS

52-Year-Old Male with Multiple Sclerosis

Mr. Ayers was diagnosed with an aggressive form of multiple sclerosis 18 years ago. His illness has not responded to conventional treatments so he's been referred to your clinic for a clinical trial.

The doctor explains that his treatment will involve giving Mr. Ayers a drug that will release stem cells from his bone marrow so they can be collected from his blood. Then Mr. Ayers will be given (1) drugs that will destroy the blood-forming cells in his bone marrow, and (2), antibodies against his T lymphocytes. Finally, the stem cells that were collected from him will be used to repopulate his bone marrow.

The doctor says, “This treatment avoids problems, such as transplant rejection, that are associated with other kinds of transplants.”

4. NCLEX-STYLE You’re talking with Mr. Ayers about his course of treatment. Which of his statements indicates a need for further instruction?

a.“It's ironic that they’re giving me antibodies against my T cells, when I already attack my own tissues."

b.“I’m gonna ask the doc to not give me the stem cells after they destroy my bone marrow.

After all, the immune cells are what's hurting me!"

c.“My T cells are just brutal. Gotta get those bad boys under control!"

d.“I’m guessing the real trouble was something that happened to my T cells."