Myeloma and lymphomas

Question 1

Multiple myeloma

Answer 1

cancer of plasma cells

Over production of a single type of immune globulin

Question 2

CRAB

Answer 2

Calcium > 11
Renal insufficiency
Anemia
Bone disease
if present=active

Question 3

Induction treatment for multiple myeloma

for 4 cycles

Answer 3

MGUS or smoldering=no treatment
VRD, VCD, KRD, Rd
Immunomodulators
Proteasome inh
Dexamath
Cyclophos

Question 4

Type of transplant in multiple myeloma

Answer 4

Auto HSCT

Question 5

VRD

Answer 5

Bortezomib
Lenalidomide
Dexamethasone

Question 6

VCD

aka CyBorD

Answer 6

Cyclophos
Bortezomib
Dexameth

Good in poor renal func

Question 7

KRD

Answer 7

Carfilzomib
Lenalidomide
Dexameth

For high risk patients

Question 8

Rd

Answer 8

Lenalidomide
Dexameth

For elderly

Question 9

Lenalidomide

Answer 9

immune modulating

teratogenic, VTE, 2ndary malignancies

Question 10

Proteosome inh ADEs

Answer 10

Need to take acyclovir
Avoid carfilzomib in Heart failure patients, caution in renal
neuropathy and thrombocytopenia

Question 11

Maintenance for myeloma

Answer 11

Lenalidomide

or Bortezomib

Question 12

Salvage therapy, all will relapse

Answer 12

repeat if >6months or
Daratumumab (CD28, alone or with Lena, Bort, causes infusion rxns BAD, need acyclovir
Elotuzumab (SLAMF7, must use as combo with lena/dex or bort/dex, give premeds)

Question 13

Myeloma supportive care

Answer 13

Bisphosphonates

Vit D, Calcium

Question 14

cells seen in Hodgkin Lymphoma

Answer 14

Reed-Sternberg cells
express CD15 and CD30
looks like owl eyes

Question 15

B symptoms of lymphoma

Answer 15

Fever, drenching night sweats

weight loss>10% of body weight

Question 16

Staging in Lymphoma

Answer 16

Ann Arbor staging
involves # of nodes, symmetry and extranodal regions
Non-hodgkins also involves IPI score

Question 17

Hodkins treatment

Answer 17

Combo chemo and radiation
don’t use growth factor!
ABVD

Question 18

ABVD

Answer 18

Doxorubicin (cardiotox, hair loss, red urine)
Bleomycin (lung tox)
Vinblastine (neurotox, blisters)
Dacarbazine (myelosup, n/v, sterile)

Question 19

Non-hodgkins lymphoma, Follicular treatment

Answer 19

Bendamustine +rituximab

RCHOP

Question 20

Non-hodgkins lymphoma, Diffuse large B-cell treatment

Answer 20

RCHOP

Question 21

R-Bendamustine

Answer 21

Rituximab (needs pre meds for infusion rxns)

Bendamustine (alkylator, myelosup, n/v, 2ndary mal)

Question 22

R-CHOP

Answer 22

Rituxan
Cyclophos
Doxorubicin
Vincristine
Prednisone