ATL Biology and Treatment Flashcards Preview

Module 2 > ATL Biology and Treatment > Flashcards

Flashcards in ATL Biology and Treatment Deck (37):
1

where are lymphomas predominantly found?

lymph nodes; lymphoid organs; spleen or GALT

2

What is involved in looking at the morphology of tumour cells?

architecture and cytology

3

How is cytogenetics carried out?

convential karyotype; FISH

4

How is the immunophenotype determined?

flow cytometry and immunohistochemistry

5

What is stage I lymphoma?

one group of nodes

6

What is stage II lymphoma?

>1 group of nodes same side of diaphragm

7

What is stage III lymphoma?

nodes above and below the diaphragm

8

What is stage IV lymphoma?

spread beyond the lymphatic system eg bone marrow, liver

9

What does the suffix E in lymphoma staging mean?

started outside the lymph nodes

10

What are the known RFs for lymphoma?

constant antigenic stimulation; viral infection; immunosuppression

11

Chronic stimulation with H.pylori antigen increases the risk of which type of lymphoma?

gastric MALT

12

Chronic stimulation with antigen in coeliac disease increases the risk of what?

small bowel T cell lymphoma

13

Why is there a 60x increase in non-hodgkins lymphoma in HIV?

loss of T cell regulation of EBV infected B cells

14

Why are immune cells particularly at risk of malignant transformation?

have rapid and multiple cell division steps; lymphocytes cut and mutate their own DNA; normal development relys on apoptosis

15

what is a high prevalence of HTLV-1?

>1% of adult population

16

Which subtype accounts for 70% of the ATLL cases in the UK?

lymphoma

17

What is seen on blood film with ATLL?

flower cell morphology

18

Where are the lesions foudn in smouldering ATLL?

skin or lungs

19

What are the clinical features of ATLL?

generalised lymphadenopathy; hepatosplenomegaly;skin lesions; lytic bone lesions; hypercalcaemia and OI

20

What is the proviral load?

% of PBMCs infected

21

What transmission route is required for the development of ATLL?

mother-to-child

22

What are the RFs for ATLL development?

Fhx; smoking; high provirla load (HLA type)

23

What is considered a high proviral load?

>4%

24

How many asymptomatic carriers are high load?

25%

25

How many high load carrier develop ATL?

20%

26

What HLA class I allele is detrimental to host protection against HTLV1

HLA-B*5401

27

What are the HTLV-1 serology tests available?

ELISA and western blot

28

How do you distinguish between ATL and peripheral T cell lymphoma in asymptomatic carriers?

for ATL need to demonstrate a monoclonal provirus in tumours

29

Why may HTLV1 infection have to happen in infancy in order to develop ATL?

before immune system has developed?

30

Why is loss of tax expression the last hit before malignancy?

allows infected cells to escape the immune system, mutations acquired meaning Tax is no longer needed

31

What is the oligoclonality index?

the spread of clones- how many of each clone present in an individual

32

What is clonal succession?

if a subclone occupying an environmental niche is lost, another population will fill its place

33

What is the treatment for lymphoma and bulky acute forms of ATLL in the UK?

chemo- CHOP-like regimen; allo HSCT

34

What is the treatment for both acute and chronic leukaemic forms of ATL?

AZT and IFNa

35

What killed patients qith chronic ATL?

half die of OI; half transform to agggressive subtype

36

What is hte name of hte anti-CCR4 antibody?

mogamulizumab

37

What is the effect of mogamulizumab in chronic ATL?

proviral load drops by 3-4 logs by end