7 - Hodgkin Lymphomas and T Cell Lymphomas Flashcards

Question

Subcutaneous Panniculitis-Like T-Cell Lymphoma

Answer 1

Hemophagocytic Syndrome

Answer 2

``` CD3+ CD8+ CD4- CD56- α/β TCR+ ```

Answer 3

Worsening malabsorption in patients with Celiac Disease Associted with HLA-DRQ Similar to MALT with H. Pylori Often the lymphoma goes away if you treat the celiac disease

Answer 4

Surgery High Chemo Allo Stem Cell Transplant

Answer 5

Cutaneous T-Cell Lymphoma Indolent Lymphoma (delayed diagnosis, history of eczema) Skin lesions can progress

Answer 6

Patch-Plaque stage Tumor (minority) Lymph node involvement Sezary syndrome

Answer 7

Systemic involvement | Peripheral blood findings

Answer 8

``` Topical Glucocorticoids (can be curative) XRT PUVA Topical chemotherapy Phototherapy Photopheresis Retinoids HDAC inhibitors Chemotherapy Transplant ```

Answer 9

NOT the same as T-Cell ALL Driven by HTLV-1 Transmitted by breastfeeding, blood transfusions, needle sharing, sexual intercourse Long latency (10 - 30 years)

Answer 10

Flower Cell

Answer 11

TAX+ CD4+ CD25+ CD30+ Occasionally

Answer 12

Lymphadenopathy Rash Hypercalcemia CNS involvement (32%)

Answer 13

26% Jamaican heritage 18% Dominican Republic 7% American born AA

Answer 14

Combination Chemotherapy: EPOCH, HyperCVAD Intrathecal prophylaxis Anti-viral therapy: Zidovudine + IFN Transplant Novel Therapies

Answer 15

``` Anti-CD25 & Anti CCR4 Antibodies HDAC Inhibitors Pralatrexate Bortezomib Lenalidomide ```

Answer 16

``` WEEKS!!!! Hella aggro Acute Subtype - 19 weeks Lymphomatous Subtype - 37 weeks Chronic Subtype - 89 weeks Smoldering Subtype - Not reached ```

Answer 17

``` Confirm hematopathology (Check for CD30, HTLV-1) Clinical Trial OR Etoposide-containing Combination Chemo If complete remission, autologous stem cell transplant ``` ``` If partial remission, relapse or worse: Vorinostat Romidepsin belinostat Pralatrexate Berntuximab Clinical Trial ```

Answer 18

Vorinostat Romidepsin Belinostat

Answer 19

``` Inhibiting the de-acetylation of histones Enforces the acetylation of histones Leads to open chromatin Transcriptional activation of tumor suppressors: p53 HSP90 NFkB STAT3 ```

Answer 20

Novel anti-folate drug Significant improvements in overall survival Marked activity in relapsed T-Cell Lymphoma Overall response rate 29%

Answer 21

Hodgkin Lymphoma | Systematic Anaplastic Large Cell Lymphoma (sALCL)

Answer 22

Member of the TNFR superfamily | Found at variable levels on the surface of different B-Cell and T-Cell lymphomas

Answer 23

Antibody-Drug Conjugant (ADC) Ab to CD30 bound to Monomethyl Auristatin E (MMAE) a potent antimicrotubule agent Binds to CD30 Drug gets endocytosed Protease-cleavable linker releases MMAE into lysosome MMAE disrupts microtubule network

Answer 24

Neuropathy

Answer 25

Nearly everyone responded | 97% patients achieved tumor reduction

Answer 26

Lymphoid neoplasm defined by presence of Reed-Sternberg (RS) cells in a reactive infiltrate 9,290 estimated new cases in 2013 1,180 deaths estimated

Answer 27

Reed Sternberg Cells Background of Eosinophils & Macrophages Cell of origin - Now thought to be B-Cell, likely post-Germinal center

Answer 28

Nodular Sclerosis - Most common, thick fibrous bands Mixed Cellularity - Most often in HIV Lymphocyte Rich Lymphocyte Depletedq

Answer 29

CD30+ CD15+ PAX5+ Often EBV+ → NFkB activation

Answer 30

Young Adults Spreads in contiguous fashion Large mediastinal mass B-Symptoms: Pruritus Pel Ebstein Fevers Painful nodes with alcohol consumption

Answer 31

Age ≥ 45 Gender Male Albumin

Answer 32

ABVD every 2 weeks Doxorubicin (Adriamycin) Bleomycin Vinblastine Dacarbazine

Answer 33

Anthracycline

Answer 34

Cardiotoxicity

Answer 35

Antineoplastic

Answer 36

Pulmonary Fibrosis

Answer 37

Anti-microtubule

Answer 38

Neuropathy

Answer 39

Alkylating Agent

Answer 40

First evaluate cardiac & pulmonary function: ECHO PFTs with DLCO of cycles given depends partly on stage and partly on IPS. Anywhere from 2 - 6 cycles Treatment is highly emetogenic, so prescribe anti-emetics Not all patients lose their hair

Answer 41

Early-Stage Involved field XRT can be used to decrease ABVD cycles to 2 - 4 Bulky Disease (mediastinal mass > 10cm or > 1/3 of chest width XRT can be used as a consolidation Improved rate of survival ``` Risk Late toxicities: Secondary malignancies (breast cancer) Pulmonary fibrosis Early CAD ```

Answer 42

Will likely do very well. This trumps IPS score.

Answer 43

Will likely relapse

Answer 44

Salvage Chemotherapy Leads to responses in 60 - 90% ``` Treatment regimens: ICE DHAP ESHAP Gemcitabine-based ```

7 - Hodgkin Lymphomas and T Cell Lymphomas Flashcards

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