HL

Question 1

Cell type a/w HL

Answer 1

Reed Sternberg

Arises from post-germinal B cells

Question 2

MC type of “classical”

Answer 2

Nodular sclerosis (70%)

Question 3

B symptoms in what % of patients

Answer 3

20-50%

Question 4

Describe Ann Arbor staging

Answer 4

o I – single LN region.
o II – 2 or more regions on same side of
diaphragm.
o III – LN regions on both sides of
diaphragm.
o IV – noncontiguous

Question 5

Treatment (firstline)

Answer 5

Early stage: ABVD (doxorubicin, bleomycin,
vinblastine, dacarbazine) for 2-4 cycles +
XRT OR 4-6 cycles alone.

Question 6

Prognosis (%)

Answer 6

Early stage: Cure rate 85-90%.

Advanced stage: Cure rate ~75%.

Question 7

Unfavorable factors

Answer 7

• Stage I/II if age >50,
• ESR >50
• B-symptoms+ESR >30
• Extranodal disease, or large mediastinal LAD
• > 2 nodal sites of involvement

Question 8

Complications for women

Answer 8

Breast Ca if received XRT

Question 9

Is F&N common?

Answer 9

No, <1%

Question 10

Is BMBx routine?

Answer 10

No, only if question of diffuse disease

Question 11

Adriamycin AE are primarily

Answer 11

cardiac

Question 12

Bleomycine AE are primary

Answer 12

lung, increased risk of PJP

Question 13

XRT SE

Answer 13

thyroid failure, radiation fibrosis syndrome (head drop)

Question 14

Treatment (salvage)

Answer 14

RICE:

• Rituxan D1
• Ifosfamide IVB D1-3 with Mesna D2-4 prior to ifosfamide and 3 & 6 hours after
• Carboplatin IVB D2
• Etoposide D1-3

*Neulasta 24-48h following last dose

Question 15

Isofosfamide primary AE, and what to do to prevent

Answer 15

Hemorrhage cystitis

• UOP >150cc/hr
• Mesna before and after
• Daily Cr monitoring

Question 16

Rituxan often administered with what non-chemo med

Answer 16

Hypersensitivity pre-meds (often Benadryl/Tylenol/Hydrocort)

Question 17

RICE is highly emetogenic. What anti-nausea meds are typical?

Answer 17

Zofran 16 mg IV daily, Emend+Dex w/ Ativan prn, +/- compazine

Question 18

RICE AE
(Hint: HAOOM is acronym)

Answer 18

Hemorrhagic cystititis
AMS (neurotoxicity)
Alopecia
Otoxicity
Mucositits

Question 19

HL and NHL are not “high risk” lymphoma. What are high risk forms ?

Answer 19

DLBCL, Burkitt’s