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Glossary

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  Ablative Transplants: a stem cell transplant using high-dose chemotherapy to destroy diseased cells and suppress the immune system; also known as "full dose" or "standard" allogeneic transplant. The patient undergoes several days of high-dose chemotherapy and possibly radiation. This is known as the conditioning regimen . The donor stem cells are then infused into the patient. This type of transplant serves three purposes: first, it destroys diseased cells, second, it suppresses the immune system to prevent rejection of the donor's healthy stem cells, and third, it creates a graft versus malignancy effect. The graft (donor cells) recognizes the cancer (malignancy) as foreign and attacks it. This ablative therapy is typically given to patients with a highly aggressive disease process.

  Afebrile: without fever.

  ALL: Acute Lymphoblastic or Lymphocytic Leukemia.

  Allogeneic Transplant (Allo): a stem cell transplant from one person to another. Stem cell donors may be related or unrelated.

  Alopecia: loss of hair.

  AML: Acute Myeloblastic, Myelogenous, or Myelocytic Leukemia.

  ANC (Absolute Neutrophil Count): the subset of the white blood cells that directly fight infections.

Anemia: a lower than normal number of red blood cells circulating in the blood.

Antibiotics: antibiotics are administered to fight off infections—from colds to more serious illnesses—at the first sign of infection or as a preventative measure

  Antiemetic: a group of drugs used to control nausea and vomiting

  Antimicrobial: medications given for prevention and treatment of bacterial, viral, and fungal infections.

  Apheresis: a procedure that circulates blood through a machine to remove cell components, for example, stem cells, platelets.

Arterial Blood Gas (ABG): a test performed on blood drawn from an artery that identifies the amount of oxygen and carbon dioxide in the blood.

  Ascites: accumulation of fluid in the abdominal cavity, often due to liver damage.

Aspirate: to remove by suction.

  Autologous Transplant (Auto): a stem cell transplant where a patient's cells are collected, frozen, then returned to the patient.

Biologic Therapy: stimulating or restoring the ability of the patient’s immune system to fight cancer

Biopsy: the removal of tissue for the purpose of assisting and diagnosis; the removal of cells or tissues that are viewed under a microscope for signs of cancer

Blast Crisis: an advanced stage of chronic myelogenous leukemia, similar to acute leukemia, where there are a large number of immature "blast" cells circulating in the blood stream.

Blood Chemistry Studies: measuring the amounts of certain substances released into the blood by organs and tissues in the body. An unusual amount of a substance can be a sign of disease in the organ or tissue that produces it.

Blood Immunoglobulin Studies: checking blood samples to measure the amounts of antibodies (immunoglobulin) and other proteins made by the myeloma cells

Blood Transfusions: replacing the patient’s blood with blood from a donor. Blood transfusions are not a cure for aplastic anemia, but they relieve symptoms by providing healthy blood cells that the patient’s blood cannot produce

Blood Typing & Cross-Matching: red blood cells contain factors which are not the same in all people. Before giving a transfusion, blood samples from donor and patient are typed (i.e., A, AB, B, 0) to see if they match. Once typed, the samples are cross-matched to double-check that they are compatible.

Bone Marrow (BM): the soft, sponge-like material in the center of bones that produces blood cells.

Bone Marrow Aspiration and Biopsy: small pieces of bone and bone marrow are removed by inserting a needle into the hipbone or breastbone. These samples are viewed under a microscope to look for abnormal cells

Bone Marrow Transplant (BMT): a transplant that uses stem cells collected from bone marrow.

Bone Marrow Transplantation: replacing diseased bone marrow with healthy bone marrow from a donor. After an appropriate donor is found, the diseased bone marrow in the patient is depleted with radiation or chemotherapy, then healthy marrow from the donor is extracted and injected intravenously into the bloodstream of the patient where it migrates to the bone marrow to begin generating new blood cells

  Candida: a type of yeast, common to the mucosa, that can cause infection in immune-suppressed patients.

Carcinoma In Situ: early stage cancer when it is confined to the place where it started

CAT or CT Scan (Computed Tomography Scan): a series of x-rays of various sections of the body, including intravenous pyelography (IVP) using a special dye to outline the urinary system, lymphangiography using a special dye that outlines the lymph system in the abdomen, and ultrasonography which creates a picture from the echoes of high-frequency sound waves bounded off internal organs.

CD34+: is a visually distinguishing feature of a stem cell not found in other cells. This unique feature helps us count the number of stem cells in your blood stream and aids in collecting stem cells.

  Central Venous Catheter (CVC): a tube surgically placed in a large vein in the upper chest or neck (e.g., Opti Flow, HICKMAN® Catheter, Quinton, GROSHONG® Catheter). Fluids, such as blood and/or chemotherapy, may be infused through this catheter and blood samples can be withdrawn from it.

Chemotherapy: drugs used to treat diseases by destroying abnormal cells or slowing their growth; administering anticancer drugs to stop the growth of cancer cells, either by killing the cells or stopping the cells from dividing (regular or high-dose)

Chest X - Ray (CXR): a radiologic study of the chest that includes the heart, lungs, and ribs.

Clinical Trial: the study of the effects of drugs, equipment, or procedures according to a formal research plan for a particular disease or group of diseases; a research study meant to help improve current treatments or obtain information on new treatments. Clinical trials are taking place testicular cancer over the country. Information about ongoing clinical trials is available from the National Cancer Institute Website

  CLL: Chronic Lymphocytic Leukemia.

  CML: Chronic Myelogenous Leukemia.

Conditioning Regimen: chemotherapy, radiation and/or immunosuppressive agents given in preparation for stem cell transplant.

Cord Blood Stem Cells: Stem cells harvested from the umbilical cord immediately following delivery.

Core Biopsy: removal of part of a lump or suspicious tissue using a wide needle

  Cryopreservation: to preserve by freezing. Autologous patients will have their stem cells cryopreserved after collection then thawed prior to transplant.

Culture: a sample of a body fluid (e.g., blood, urine) or tissue taken to detect the presence of an infection and to identify the organism responsible.

Cytogenetic Analysis: a test in which cells from the patient’s blood or bone marrow are viewed under a microscope to look for specific changes in chromosomes, such as the Philadelphia chromosome

  Cytomegalovirus (CMV): a virus that is detectable in the majority of adults. The virus often reactivates when a patient is immunosuppressed. When active, the virus can cause an infection in the lungs (pneumonia), intestine (enteritis), or blood (viremia).

  Cytoxan® (CTX or CY): the brand name of a chemotherapy drug (cyclophosphamide) used to destroy cancer cells or to mobilize stem cells.

Day 0: the day a patient receives his/her stem cell transplant. The days before transplant are called ÒminusÓ days (e.g., Day Ð 7 means there are seven days until transplant) and the days following transplant are called ÒplusÓ days (e.g., Day +2 is two days after transplant).

Differential (diff): the breakdown of the white blood cell components, such as lymphocytes, neutrophils, eosinophils and monocytes.

DLCO: a test of the lungs that determines the amount of oxygen taken into the body and carbon dioxide expelled.

Donor Cell Infusion (DCI): an additional infusion of donor cells given to Allogeneic patients following their transplant to induce a Graft versus Malignancy effect.

Donor Lymphocyte Infusion: DLI may be used after a stem cell transplantation. Lymphocytes (a type of white blood cell) from the stem cell transplant donor are removed from the donor’s blood and stored. The donor’s lymphocytes are then given to the patient through one or more infusions. The lymphocytes see the patient’s cancer cells as not belonging and attack them.

Electrolytes (lytes): mineral salts that are normally found in the blood stream. The correct level of each electrolyte is important for the overall functioning of the body. Examples are sodium, potassium, and magnesium.

Electrophoresis: test in which blood or urine samples are checked for M proteins

  Emesis: vomiting.

Engraftment: the growth of new bone marrow cells following transplant. White blood cell engraftment is determined by the ANC: three consecutive ANC's greater than 500 define engraftment.

Estrogen or Progesterone Receptor Test: measures the amount of estrogen and progesterone hormone receptors in cancer tissue showing whether hormone therapy may be effective in stopping the cancer from growing

Etoposide: A type of chemotherapy that inhibits cancer cell growth.

Excisional Biopsy: removal of an entire lump or suspicious tissue

Familial (or Hereditary) Amyloidosis: A very rare form of the amyloidosis, it is found in nearly every ethnicity. The amyloid deposits of this type are usually made up of the mutated transthyretin protein which is manufactured by the liver.

FDA: Food and Drug Administration. Agency of the Public Health Service.

  Febrile: fever.

Foley Catheter: a tube placed in the bladder to drain urine.

Gallium Scan: gallium, a radioactive material, is injected into the blood stream, where it collects in bones or other tissues where cancer cells are growing rapidly

Germ Cell Tumors: the most common type (over 9 out of 10 cases) of testicular cancer, germ cell tumors begin in the cells that make sperm. Most germ cell cancers begin as carcinoma in situ (CIS), a cancer that is not invasive (has not spread from where it started). Germ cell cancers are divided into two types: seminomas and nonseminomas.

GI tract: gastrointestinal (digestive) tract.

Graft Versus Host Disease (GVHD): a condition where transplanted cells from the donor attack the cells of the host's body. In the first 100 days, the tissues most likely to be attacked are the skin, GI tract , and the liver.

Graft Versus Malignancy or Leukemia: a phenomenon where transplanted cells of the donor attack the patient's malignant cells.

Granulocytes: white blood cells that have granules containing enzymes and other substances that destroy the germs that cause infections. Monocytes, neutrophils, basophils and eosinophils are testicular cancer granulocytes

Growth Factor Drugs: drugs such as granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF) and cytokines may help stimulate the bone marrow to produce new blood cells

Growth Factors: a protein that stimulates the production and growth of blood cells, e.g., Neupogen (G-CSF), Aranesp or Neulasta.

Harvest: the process of collecting stem cells from patients' or donors' peripheral blood , bone marrow or cord blood.

  Hematocrit (crit, Hct): the percentage of red blood cells (normal ranges for women are 37-47% and men are 42-54%).

  Hematology: a medical specialty that focuses on diseases of the blood and blood forming tissues.

  Hematuria: blood in the urine.

  Hemmorrhagic Cystitis: bleeding from the lining of the bladder caused by irritants, such as cytoxan and ifosphamide or viruses such as BK, CMV or adeno.

  Hemoglobin (Hgb): iron-containing protein found in red blood cells that carries oxygen (normal ranges for hemoglobin are between 12 - 18 Gm/dl).

Herpes Simplex Virus (HSV): a virus that causes infections such as cold sores. Over 90% of adults have been exposed to this virus by age 20.

High-Dose Chemotherapy: There are several chemotherapy drugs that can be utilized. Chemotherapy regimens vary depending on the type of cancer, the stage of the cancer, and the available chemotherapy protocols. Your physician will discuss the best drugs and doses for your disease.

High-Dose/Myeloablative Regimens: The purpose of high-dose regimens is to destroy a greater number of cancer cells than with standard doses of chemo/radiotherapy.

  HLA Typing (Human Leukocyte Antigen Typing): molecular testing of blood DNA used to find donors for allogeneic transplant . This test is run primarily from blood samples.

Hodgkin Lymphoma: HL

Hormone Therapy: removing hormones or blocking their action to stop cancer cells from growing. Hormones produced by glands in the body can cause certain cancers to grow, when the cancer cells have certain places where hormones can attach, called receptors

Immunophenotyping: identifying cells based on the types of antigens or markers on the surface of the cell to diagnose the subtype of AML

Immunosuppressive Therapy: administering drugs that alter or suppress the immune system to correct an autoimmune disorder that’s causing the body’s immune system to attack and damage cells in the bone marrow

Incisional Biopsy: removal of part of a lump or suspicious tissue

Infertility: the inability to start or maintain a pregnancy

Intrathecal Chemotherapy: administering anticancer drugs by injecting them into the fluid-filled space between the thin layers of tissue covering the brain and spinal cord

Irradiation: treatment with x-rays or other radioactive substances. See TBI .

Liver Function Tests (LFTs): lab tests performed on a blood specimen that gives information about liver function, for example, bilirubin and transaminases.

  Low Microbial Diet (LMD): a diet designed to eliminate foods which often contain large numbers of microorganisms/bacteria.

Lymph Node Biopsy: removal of multiple myeloma or part of a lymph node

Lymphatic Tissue: tissue found in the lymph nodes and related organs (spleen, bone marrow, tonsils and thymus) that make up the body’s immune and blood-forming systems.

Lymphocytes: these blood cells are the main cells that make up lymphoid tissue, a major part of the immune system, and are found in the lymph nodes, thymus, spleen, tonsils, adenoids, bone marrow, and throughout the digestive and respiratory systems. The two types of lymphocytes are known as B lymphocytes (B cells) and T lymphocytes (T cells)

Male Hormones: a synthetic version of the male hormone androgen, which stimulates blood cell production, is being investigated as treatment for patients with mild to moderate aplastic anemia

Mammogram: x-rays of the breast

  MDS: Myelodysplastic Syndrome.

  Metastatic: spread of cancer from an organ or tissue of origin to another part of the body.

  MM: Multiple Myeloma.

Mobilization (priming): the process used to move stem cells from the marrow into the circulating blood. Growth factors , with or without chemotherapy, are used in this process.

Monoclonal Antibodies: using laboratory-produced substances that can locate and bind to cancer cells

Monocytes: these blood cells protect the body against bacteria

MRI (Magnetic Resonance Imaging): a type of scan that takes pictures of the body using magnetic fields and radio waves.

  Mucositis: inflammation and ulceration of the mucous membranes. Transplant patients can experience mucositis in the mouth, throat and esophagus.

MUD (Matched Unrelated Donor Transplant): a transplant in which the donor and recipient are unrelated but have matching HLA types.

Needle Biopsy or Fine-needle Aspiration Biopsy: removal of part of a lump. suspicious tissue or fluid using a thin needle.

  Neutropenia: a low number or lack of the neutrophils needed to fight infection.

NHL: Non-Hodgkin Lymphoma.

  Non-myeloablative transplant (reduced intensity; mini-allogeneic): an Allogeneic stem cell transplant that uses lower doses of chemotherapy and/or radiation. The goal of the therapy is to make room for the donor cells.

Oncologic Drug Advisory Committee Meeting (ODAC): This committee formed by the FDA of external experts to advise the FDA in the evaluation of marketed and investigational drugs for use in the treatment of cancer. The Committee is comprised of a core of thirteen voting members from the fields of general oncology, pediatric oncology, hematologic oncology, immunologic oncology, biostatistics and other related professions.

Source: Inex Pharmaceuticals

Oncologic Drugs Advisory Committee (ODAC): This committee formed by the FDA of external experts to advise the FDA in the evaluation of marketed and investigational drugs for use in the treatment of cancer. The Committee is comprised of a core of thirteen voting members from the fields of general oncology, pediatric oncology, hematologic oncology, immunologic oncology, biostatistics and other related professions.

Source: Inex Pharmaceuticals

Oncology: the study of cancer.

P/SL: Presbyterian/St. Luke's Medical Center.

Packed Red Blood Cells (PRBC): a method of preparing red blood cells for transfusion.

Palliative Therapy: therapies to relieve symptoms and improve quality of life

  Pancytopenia: a condition where a patient has fewer white blood cells, red blood cells and platelets than normal.

Patient Controlled Analgesic (PCA): a method of delivering intravenous pain medications with a pump that allows the patient to self-administer the medication when needed.

Performance Score: a method of rating a patient's level of activity or performance status. This score gives an overall estimate of physical health. Performance status is an important factor in determining eligibility for transplant.

  Perineum (Perineal Area): the area between the rectum and the external genitalia. This area is vulnerable to infection during periods of neutropenia .

Peripheral Blood: blood cells found in blood vessels (as opposed to blood cells found in the bone marrow ).

Peripheral Stem Cell Transplants: peripheral stem cells are taken from the blood of a donor and given to the patient. Research is continuing to determine the effectiveness of this treatment for aplastic anemia.

  Perirectal: the area around the rectum.

  PET Scan (Positron Emission Tomography): a scan that takes pictures of the body and shows whether there are unusually high amounts of nutrients being processed; an imaging test to find malignant tumor cells in the body by injecting glucose into the body using a rotating scanner to show where more glucose is being used (malignant tumor cells take up more sugar than normal cells)

Philadelphia Chromosome: an abnormally short chromosome (number 22), usually referred to as the Ph-chromosome

PICC: a peripherally inserted central catheter that is inserted into a large vein in the arm. This catheter can be placed at the bedside by a trained nurse or in radiology by a physician.

Plasmapheresis: treatment removing blood from and vein and separating the blood cells from the blood plasma. The remaining parts of the blood (mostly red blood cells) are returned through another vein, relieving symptoms of myeloma

Platelet (PLT): a type of blood cell that helps the blood to clot. The normal range for platelets is between 150,000 - 500,000/mm 3 . An increased risk of serious bleeding occurs when platelets drop below 50,000/mm 3 .

Platelets: these blood cells plug up holes in blood vessels caused by cuts or bruises

  Pluripotent Stem Cell: a primitive cell from which all other blood cells originate; also called a stem cell.

  Prophylactic: preventive.

Protocol: a standardized plan of treatment and evaluation designed to address a research question.

Psychosocial: the psychological and social aspects of a person, for example, marital status, age, education, support network, and coping skills.

Pulmonary Function Tests (PFTs): a test used to evaluate the capacity of the lungs by measuring the flow of air into and out of the lungs.

Radiation Therapy: using high-energy radiation from x-rays, gamma rays, neutrons and other sources to kill cancer cells and shrink tumors

Randomization: random assignment of patients to different types of treatment specified in a clinical trial.

Red Blood Cell (RBC): a type of blood cell containing hemoglobin that transports oxygen throughout the body.

Reduced Intensity: also known as non-myeloablative or ÒminiÓ transplants. Lower doses of chemotherapy and possibly radiation are used as the conditioning regimen, followed by the infusion of donor stem cells. In this type of transplant, the purpose is not to replace the pa

Reed-Sternberg Cells: a type of malignant B lymphocyte and distinguish Hodgkin lymphoma from other types of lymphoma (named after two doctors who discoverd them).

Relapse: recurrence of disease.

Related Donor: A stem cell donor that is a family member.

  Respiratory Syncytial Virus (RSV): a common virus that causes a cold in healthy adults. However, it can lead to serious pneumonia in patients with a weakened immune system.

Restaging: a system of re-evaluating your disease characteristics and spread. Also, assessing your baseline organ functionality to determine your body's ability to tolerate the rigors of high-dose chemotherapy treatments associated with a transplant. Restaging may involve x - rays, scans, blood tests, biopsies, pulmonary function tests, heart scans, EKG, and urine tests.

RMCC: Rocky Mountain Cancer Centers.

  SAA: Severe Aplastic Anemia.

Secondary Amyloidosis: caused by a chronic infection or imflammatory disease (such as rheumatoid arthritis, familial Mediterranean fever, osteomyelitis, or granulomatous ileitis). The amyloid deposits that are produced by this type of amyloidosis are made up of a protein called the AA protein.

Secondary Testicular Tumors: tumors that start in another organ and then spread to the testicle. Among men over 50, secondary testicular tumors are more common that tumors that begin in the testicle. The prognosis depends on the type and stage of the original cancer.

Solid Tumor: a cancer that originates in an organ or tissue other than the bone marrow or lymph system (e.g., Breast or Colon cancer).

Staging: a system of quantifying disease characteristics and spread. Staging may involve x - rays, scans, blood tests, and biopsies.

Staging Laparotomy: a surgical procedure to inspect and biopsy lymph nodes in the abdomen and liver and to remove the spleen to determine the stage of cancer

Stem Cell: a cell from which all other blood cells originate; also called a pluripotent stem cell

Stem Cell Transplant: also known as non-myeloablative or ÒminiÓ transplants. Lower doses of chemotherapy and possibly radiation are used as the conditioning regimen, followed by the infusion of donor stem cells. In this type of transplant, the purpose is not to replace the patients destroyed marrow cells, as the patientÔs marrow function would return to normal if donor cells were not administered. The conditioning regimen is given to suppress the patient' s marrow function for a short time period allowing the donor cells to engraft . The donor cells are given in order to create a graft-versus-malignancy effect. The term ÒminiÓ transplant, however, is somewhat misleading. Although patients receive less toxic dosages of chemotherapy and radiation, and may feel well early in the post transplant process, they are still at risk to develop serious and potentially life-threatening side effects. These side effects often begin 30-60 days post-transplant when the new immune system is gaining strength.

Stem Cell Transplantation: a method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

Stereotactic Body Radiation Therapy: A radiation therapy technique that uses special equipment to position the patient and precisely deliver a large radiation dose to a tumor and not to normal tissue.

  Stomatitis: inflammation and ulceration of the lining of the mouth. Stomatitis is one type of mucositis .

Stromal Tumors: tumors that begin in the cells that make hormones and in the supportive tissues (stroma) of the testicles. These tumors are often benign and do not spread beyond the testicle; however, when stromal cell tumors spread to other parts of the body, they have a poor prognosis because they do not respond well to treatments.

  Syngeneic Transplant: a stem cell transplant from one HLA identical twin to the other.

Thoracentesis: removal of fluid by needle from the space between the lining of the chest and the lungs

  Thrombocytopenia: a lower than normal number of platelets defined as less than or equal to 50,000/mm 3 .

Total Body Irradiation (TBI): a type of irradiation delivered to the entire body.

Total Parental Nutrition (TPN): intravenous (IV) fluids infused through a central venous catheter to provide nutrients, vitamins, and minerals that normally would be received from food. Also called hyperalimentation (HA).

Transfusion Therapy: to replace red blood cells, platelets, and sometimes white blood cells, to relieve symptoms and improve quality of life

Treatment Guidelines: a nationally recognized standard of care for the treatment of a specific disease.

Tumor Lysis Syndrome: A complication that can occur after having chemotherapy treatment.

Tyrosine Kinase Inhibitor: Imatinib (Gleevec) is a tyrosine kinase inhibitor. It blocks the enzyme, tyrosine kinase, that causes stem cells to develop into more white blood cells (blasts) than the body needs

Unrelated Donor (URD Transplant): an Allogeneic transplant where the donor and recipient are unrelated.

URI: Upper Respiratory Infection.

Watchful Waiting: careful follow-up testing without immediate treatment

White Blood Cell (WBC): the cells that help your body to fight infections. Normal ranges for white blood cells are between 4,500-11,000/mm3. Different types of white blood cells include neutrophils, lymphocytes, monocytes, and eosinophils.

  Xerostomia: dry mouth caused by decreased or absent saliva production, which is a side effect of TBI and chemotherapy.