ALL

Question 1

difference between bone marrow biopsy and lumbar puncture tap

Answer 1

bone marrow - examines size and # of leukemic cells; also finds out type of lymphocytes involved (B/T)
lumbar tap - test to see if CSF is involved

Question 2

which type has better prognosis B or T type

Answer 2

B

Question 3

Sanctuary sites?

Answer 3

testes, retina/optic nerve

Question 4

define sanctuary sites

Answer 4

an area of the body that is poorly penetrated by pharmacological agents and therefore is a place in which tumor can escape the effects of drug therapy.

Question 5

steps of chemo

Answer 5

induction -consolidation - maintenance - (CNS prophylaxis)

Question 6

induction

Answer 6

immediately after diagnosis

1 month

Question 7

consolidation

Answer 7

given after remission achieved

4-8 months

Question 8

Maintenance

Answer 8

kills of residual disease, or recurrence

Question 9

when is CNS prophylaxis given

Answer 9

high risk pts
t-cell diagnosis
high initial WBC

Question 10

dose for CNS prophylaxis

Answer 10

1200/24 or 20

Question 11

cranial field borders

Answer 11

sup - fall off, flash
ing - include cribriform plate, temporal fossa; to level of c2 posteriorly, includes retina and optic nerve
post- fall off, flash
ant - fall off, flash

Question 12

when is RT done for ALL

Answer 12

prep for bone marrow transplant
CSI
testicular irradiation
large mediastinal mass
palliation

Question 13

difference between autologous and allogeneic stem cell transplant

Answer 13

auto-from transplant from same person (after conditioning regimen)
transplant healthy from donor

Question 14

dose for a TBI?

Answer 14

1200-200cGy given BID for 3 days

Question 15

when do we treat a pt with TBI

Answer 15

prep for a bone marrow transplant,

wipe out all bad bone marrow so new one can take over

Question 16

were is TBI dose prescribed?

Answer 16

umbilicus

Question 17

dose given for testicular relapse?

boost when?

Answer 17

2400cGy-2600cGy/150-200cGy/fx

after TBI might boost with 400cGy

Question 18

for ALL when do we do CSI

what dose?

Answer 18

when there are positive cells in CSF

helmet field: 2400/150cGy
Spine field: 1500cGy/150cGy

Question 19

spine field borders for CNS?

Answer 19

sup - junction of inf cranial field
inf - below s2
lat - width should cover the entire vertebral bodies in all areas

Question 20

acute side effects of CSI

Answer 20

hematopoietic - decrease in blood counts
somnolence syndrome - characterized by drowsiness and malaise
l’hermitte’s syndrome
GI effects - NV, diarrhea

Question 21

late effects of CSI

Answer 21

motor-sensory loss
growth delays - hypothalmic-pituitary dysfunctions - irradiation to the CNS
myelopathy
secondary tumours

Question 22

acute side effects TBI

Answer 22

NV, diarrhea, anorexia
effect mucosa of: mouth, pharynx, bladder
skin rxns: itch, tingling, bruise, dry/ineleastic skin (cracks easy)
alopecia
interstitial pneumonitis
malaise (discomfort)

Question 23

chronic side effects TBI

Answer 23

permanent sterility
cataracts
hepatic fibrosis
radio-necrosis of genital tissue, muscle, or kidney

Question 24

where might TLDs be placed for TBI

Answer 24

knees
umbilicus
neck
head
armpits
pelvis
shoulders