Hematology Week 2: Approach to a Patient with a Hematologic Neoplasm

Question 1

When should you expect hematologic neoplasm?

Answer 1

• History is key
• Physical exam
• Labs
• Symptoms

Question 2

Typical symptoms of a Hematologic Neoplasm

Answer 2

B symptoms

• fever without infection
• unintended weight loss
• night sweats
• severe fatigue

A palpable or visible mass

Pain

• visceral
• bone

Question 3

Typical CBC of a Hematologic Neoplasm

6 listed

Answer 3

• Anemia (Macrocytosis > Microcytosis)
• Neutropenia
• Thrombocytopenia
• >1 cell line involved raises suspicion
• Duration of symptoms
• Lymphadenopathy

Question 4

Imaging inHematologic Neoplasm

Answer 4

PET Scan radioactive glucose (glucose goes to sites that have high energy) lymphoma lights up in lymphoma

Question 5

Biopsy in Hematologic Neoplasm

Answer 5

• peripheral blood
• BM biopsy (aspirate and core)

Question 6

Types of lymph node biopsies

3 listed

Answer 6

Question 7

Staging

Answer 7

• Example Ann Arbor Staging System for Non-Hodgkin’s Lymphomas
• Hodgkin Staging is the same except for an A or B denoting the presence of B symptoms

Question 8

Treatment of Hematologic Neoplasm

Answer 8

Question 9

Treatment of Hematologic Neoplasm

Answer 9

Question 10

Types of medications

Answer 10

Question 11

Supportive Care Types

3 listed

Answer 11

Question 12

Clinical Trials

Answer 12

Question 13

Response to treatment: Partial

Answer 13

any positive response that is less than complete

Question 14

Response to treatment: Complete response

Answer 14

Having no evidence of disease by any measure

Question 15

Response to treatment: Remission

Answer 15

Patients tend to use a synonymous with complete remission

Question 16

Response to treatment: Cure

Answer 16

Free from that disease for 5 years post-treatment with reasonable expectation that it will not recur

Question 17

Response to treatment: Progressive Disease

Answer 17

disease growth either on or off treatment

Question 18

Response to treatment: Relapsed Disease

Answer 18

Recurrence after complete response

Question 19

Response to treatment: Refractory Disease

Answer 19

not responsive to multiple therapies

Question 20

When can you expect a cure?

Answer 20

Question 21

Stem Cell Transplant

Answer 21

HSCT are usually done in peripheral blood now whereas bone marrow was once sucked out and poked repeatedly

Question 22

Autologous Stem Cell Transplant

Answer 22

saved stem cells in freezer then give enormous chemotherapy and rescued with saved cells

Question 23

Allogeneic Cell Transplant Matching

Answer 23

Question 24

Allogeneic Cell Transplant Procedure

Answer 24

Question 25

Allogeneic Stem Cell Transplant Risks

Answer 25

Question 26

Allogeneic Cell Transplant Immunocompromise

Answer 26

Question 27

Allogeneic Stem Cell Transplant Indications

Answer 27

Question 28

Allogeneic Stem Cell Transplant Obstacles

Answer 28