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Old 03-07-2012
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Warning! USMLERx Question Mistake

A 32-year-old man with Hodgkin’s lymphoma is scheduled to undergo a bone marrow transplant. HLA typing of his immediate family shows that his identical twin brother is a suitable match for a bone marrow graft. Which of the following grafts is most likely to be successful in this patient?

A. Allogeneic
B. Autogeneic
C. Combination graft
D. Syngeneic
E. Xenogeneic


The answer is A. An allograft is a graft taken from a genetically different member of the same species. Recipients require posttransplant immunosuppression to prevent allograft rejection. Rejection is a T-cell mediated process.

B is incorrect. An autogeneic graft, also known as an autologous or self-graft, would be a transplantation of the patient’s own tissue from one site to another. They are commonly used for skin grafts, coronary artery bypass surgery (vein), and bone or cartilage transplants. There is no need for immunosuppresion. However, an autologous graft is not an option for this patient, because Hodgkin’s lymphoma affects bone marrow throughout the body.

C is incorrect. A combination graft is usually composed of a mixture of autogeneic and allogenic tissues.

D is incorrect. A syngeneic graft is a graft harvested from a patient’s genetically identical twin sibling, and is a type of allogeneic graft. Syngeneic grafts are nearly always successful, and the recipient does not require posttransplant immunosuppression nor does he or she develop graft-versus-host disease. An allogeneic graft, harvested from another member of the same species, would be an appropriate response if this patient did not have a twin brother. It would be less successful in this case, because allograft recipients require posttransplant immunosuppression.

E is incorrect. A xenogeneic graft, or heterograft, is a graft taken from a different species. This type of graft is always rejected in an immunocompetent host.

The correct answer is D but over the website its mentioned A so be careful
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patho2012 (03-07-2012)

Old 03-07-2012
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Default Concordance for Hodgkin disease

Hodgkin dz are mostly of 2 types: early adulthood form (15-40yo) and late adulthood form (>55yo). The risk of developing juvenile type of Hodgkin dz for identical twins (ie, monozygotic sibbling) is very high. The risk for dizygotic bro/sis is similar to that of other sibblings. Putting together, it is worth questioning to receive a syngeneic graft from an identical twin or an allograft from a normal person. I would choose a syngeneic allograft over an allogeneic graft since I have no solid experience in this field. Just my personal thought.
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Old 03-07-2012
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I took this question in one of the Kaplan's Qbanks and the answer is D syngeneic
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