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hemato-onco > behandelingen > Flashcards

behandelingen Flashcards

(65 cards)

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1
Q

ferriprieve anemie

A

PO Fe

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2
Q

megaloblastische anemie

A

Vit B12 + FZ!!
als je niet zeker bent van wat de oorzaak is, sowieso allebei tegelijk geven!
(als je alleen FZ geeft zonder vit B12 bij een vit B12 tekort, dan kunnen de neurologische symptomen erger worden)

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3
Q

vit B12 tekort

A

denk aan GI problemen!

-> hydroxycobalamine IM

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4
Q

FZ tekort

A

denk aan dieet!!

FZ PO + dieet aanpassen

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5
Q

anemie door renale insuff

A

EPO + Fe (IV/PO)

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6
Q

ACD

A

onderliggende aandoening

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7
Q

WAIHA

A
  • steroiden
  • anti-CD20
  • splenectomie
  • immunosuppresiva
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8
Q

KAIHA

A

koude vermijden
vaak zelflimiterend
anti-CD20
behandel onderliggende ziekte

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9
Q

hereditaire sferocytose

A

FZ

splenectomie

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10
Q

PNH

A

FZ+Fe
eculizumab
allo-STx

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11
Q

pyruvaat kinase deficientie

A

FZ

splenectomie

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12
Q

G6PD deficientie

A

oxidatieve stress vermijden

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13
Q

sikkelcelanemie

A

preventief: FZ, uitlokkende factoren vermijden
complicaties: O2, vocht, AB, analgetica
causaal: hydrea, transfusie, STx, gentherapie

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14
Q

thalassemie major

A

transfusie
allogene STx
gentherapie

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15
Q

thalassemie intermedia

A

FZ + complicaties opvolgen

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16
Q

thalassemie minor

A

geen Fe supplementen!!!

+ genetische counseling bij kinderwens

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17
Q

ITP

A 
corticoiden, IV Ig
anti-CD20
splenectomie
transfusie
TPO-R agonist
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18
Q

TTP

A

plasma-uitwisseling
corticoiden
anti-CD20

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19
Q

HUS

A

conservatief
AB
soms tijdelijk diayse

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20
Q

aHUS

A

levenslang anti-CD5 (eculizumab)

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21
Q

fanconi

A

supportief
androgenen, G-CSF
allogene STx
screening maligniteiten

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22
Q

dyskeratosis congenita

A

androgenen, G-CSF
allogene STx
screening maligniteiten

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23
Q

Schwachman diamond

A

exogene pancreasenzymen
supportieve transfusies
allogene STx

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24
Q

balckfan diamond

A

spontane remissie
corticoiden
supp transfusies
allogene STx

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25
GATA2 deficientie
monitoring + preventie infecties monitoring evolutie MDS/AML allogene STx familiale counseling
26
non-severe AA
afwachten
27
severe AA
<40j + donor -> allogene STx >40j of geen donor -> immuunsuppressie (corticoiden + cyclosporine + antithymocytglobuline 6m + elthrombopag) ouderen: cyclosporine, elthrombopag
28
low risk MDS
transfusie volgens nood | transfusie nood beperken: EPO, luspatercept, lenalidomide
29
high risk MDS
supportief azacytidine allogene STx
30
klassieke PNH
FZ, Fe transfusies eculizumab (anti-co)
31
aplastische PNH
FZ transfusies cyclosporine allogene STx
32
CML
TKI | heel soms allogene STx bij blijvend therapiefalen
33
polycythemia vera
``` acuut: aderlating chronisch - aspirine - CV hygiene - low risk (<60j): periodieke aderlating - high risk (>60j): hydroxyurea, JAK2-inh, interferon ```
34
essentiele thrombocythemie
``` acuut: aderlating chronisch - aspirine - CV hygiene - low risk:afwachten - high risk: hydroxyurea, anagrelide, interferon ```
35
myelofibrose
ifv leeftijd + prognostische score - afwachtend - supportief (transfusie, EPO) - JAK2-inh - hydroxyurea - allogene STx
36
CLL
cytoreductie supportief behandeling complicaties
37
CLL <65 + goede conditie
fludarabenide + cyclosporine + anti-CD20 om de 4w IV
38
CLL oudere patienten
ibrutinib goed verdragen
39
hairy cell variant
geen behandeling -> slechte prognose
40
hairy cell leukemia
goede prognose als behandeld
41
T-PLL
antiCD52 + allogene STx
42
LGL
afwachten ernstige cytopenie: CS, cyclofosfamide, cyclosporine, methotrexaat infectie -> GF
43
stadium I-II gunstig Hodgkin
2x chemo + radio
44
stadium I-II ongunstig Hodgkin
2x chemo + 2-4x chemo +/- radio
45
stadium III-IV hodgkin
2x chemo + 4x chemo +/- radio
46
herval/ geen complete metabole remissie bij Hodgkin?
``` chemo + (autologe)STx immunotherapie - anti-CD30 - immune checkpoint inh -( allogene STx) ```
47
non-Hodgkin
Chemo + rituximab | kijken naar mate van ziekte reductie/eradicatie en impact van ziekte en behandeling
48
laaggradig non-hodgkin zonder klachten
afwachten
49
laaggradig non-hodgkin met klachten
eenvoudige immunotherapie schema's
50
agressief NHL
altijd intensieve immuno-chemo
51
intermediair NHL
intensieve immunochemo
52
herval NHL
autologe/allogene STx | CAR-T
53
cytoreductie MM
``` steroiden hoge dosis chemo immunomodulerende middelen (-imid) proteasoom inhibitoren (-omid) monoclonale AS (daratumumab) ``` -> nu CS + imid/omid (evt. + autologe STx)
54
herval MM
2e lijn: daratumumab | hogere lijnen: allogene STx, CAR-T
55
ziekte van Waldenstorm
plasmaferese immunotherapie ibrutinib
56
acute leukemie
remissie inductie consolidatie onderhoud
57
remissie inductie acute leukemie
chemo + doelgerichte therapie ! hoog risico tumor lysis syndroom! + supportief
58
niet curatieve behandeling AML
hypomethylerende agentia | + BH3 mimetica (venetoclax)
59
niet curatieve behandeling ALL
TKI (als Ph(+))
60
ABO mismatch
``` stop transfusie!!! vocht corticoiden adrenaline + investigatie ```
61
TACO
diuretica | PC traag toedienen
62
chronische transfusie
EPO, luspatercept en aanpak van secundaire anemie aanpakken -> transfusie nood beperken !! Fe stappeling -> ferritine opvolgen + chelatie
63
TRALI
supportief
64
T-lymfopenie
VZV en PJP profylaxe
65
B-lymfopenie
Ig's profylaxe

hemato-onco (4 decks)

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