3.27 WEIR Lymphomas II Flashcards Preview

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Flashcards in 3.27 WEIR Lymphomas II Deck (10):
1

What 4 major factors must a doctor consider when he/she decides if cure is possible for a patient with lymphoma?

Tumor Histology

Tumor Stage

Condition of patient

Avaliable Therapies 

2

Name the most common indolent lymphoma. Aggressive lymphoma?

Indolent: Follicular lymhoma

Aggressive: Diffuse Large B cell lymphoma

Very Aggressive: Burkitt's (t(8;14))

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3

Be able to stage a patient with lymphoma

-Stage I: single node or lymphoid structure

--Stage IE: extranodal is the sole site of involvment

-Stage II: Two or more lymph regions one side diaphragm

-Stage III: both sides of diaphragm

Stage IV: Lymph node involvement plus an extranodal site of involvement

How to stage: history and exam, CAT scan chest, abdomen and pelvis, BM aspirate and biopsy w/ flow, Gallium or PET scan, Chemistries: CBC, LDH and CSF is high risk disease

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4

What are the major treatment decision differences between indolent and aggressive lymphomas?

Indolent: (1) Higher stage (2) Slower progression (3) Response to simple therapies (4) incurable except with stage 1-2 (allogenic transplant may cure) (5) survival independent of early treatment (6) treat when symptomatic 

Aggressive: (1) often lower stage (2) rapid progression (3) requires complex therpies (4) potential cure** (5) early therapy required, treat right away

5

Understand the mechanism and sites of action of rituximab and ibrutinib.

Rituximab: CD20: increased survival when added to CHOP

Ibrutinib: Bruton Tyrosine Kinase Inhibitior (Bcell Refractory disease)

-Prevents Kinase to eventual activation of NFkB which will induce transcription of survival signals to avoid apoptosis

Other drugs mentioned:

Alemtuzumab (CD52, CLL and T-cell leukemia)

Brentuximab vedatin: CD30 (Hodgkin and CD30+ T cell lymphomas)

Inotuzumab ozogamicin: CD22

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6

What is the name of the most common cutaneous lymphoma and what cell can you find in the blood in some of these patients?

Mycosis Fungoides

-T cell derived (usually indolent)

Stage 4: seizry syndrome

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7

What is a common complication of radiation therapy in young Hodgkin’s Disease women?

-They are at an increased risk for breast cancer w/n 30yrs of treatment, some showing up as early as 15 yrs

-Reconsidering chemo therapy for these patient

8

Name two complications of CLL.

-Hypogammaglobulinemia: reoccuring infections

-Autoimmune cytopenias

-Anemia

-Splenomegaly

-Lymphadenopathy

-Lymphocytosis

-Often asymptomatic

9

Name two poor prognostic chromosome abnormalities in CLL.

-High Stage

-Increased lymphocyte doubling time

-Deletion 17p, 11q23 (p53)

-Unmutated VH gene, ZAP-70, CD38

 

10

When is BMT used in Lymphomas?

-Indolent lymphomas that are stage I or II

-Aggressive lymphomas that relapse