Haematology 12 - Lymphoma 2 Flashcards Preview

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Flashcards in Haematology 12 - Lymphoma 2 Deck (27)
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1

How do Reed Sternberg cells appear on the blood film?

Giant cell surrounded by reactive eosinophils

2

What is the age distribution of Hodgkin's lymphoma?

Females 20-29
M=F, elderly

3

What are the symptoms of Hodgkin's lymphoma?

Painless lymphadenopathy, that becomes painful on drinking alcohol
Constitutional B symptoms
If advanced lymphadenopathy, may --> obstructive symptoms

4

What is the cause of constitutional B symptoms in lymphoma?

Hyper-catabolic state

5

Which investigation is used to diagnose hodgkin's lymphoma, and which diagnosis is used for staging?

Diagnosis: LN biopsy
Staging: FDG-PET

6

Recall the different stages of Hodgkin's lymphoma

I: one group of nodes
II: >1 group of nodes, on one side of the diaphragm
III: Nodes on both sides of the diaphragm
IV: extranodal spread
Then:
A: no B symptoms
B: one/ any of fever/ weight loss/ night sweats

7

Which subtype of lymphoma is most likely to affect young women?

Nodular sclerosing Hodgkin's

8

What type of chemotherapy is used in Hodgkin's lymphoma?

ABVD

9

After how many cycles of chemotherapy for Hodgkin's lymphoma should the FDG-PET be repeated to check response?

2

10

What is the risk of giving radiotherapy for Hodgkin's lymphoma?

It produces a lot of collateral damage, and when given alongside chemotherapy increases the risk of secondary malignany significantly

11

Recall 4 prognostic markers in lymphoma

1. LDH
2. Performance status
3. HIV serology
4. Hep B serology

12

How aggressive is diffuse large B cell non-Hodgkin's lymphoma?

High grade

13

How aggressive is follicular non-Hodgkin's lymphoma?

Indolent

14

How is diffuse large B cell non-Hodgkin's lymphoma treated?

R-CHOP and immunotherapy

15

What mutation is commonly associated with follicular non-Hodgkin's lymphoma?

t(14;18)
Translocation of Bcl2 --> oncogene

16

Which subtype of non-Hodgkin's lymphoma is associated with chronic H. pylori?

Extra-nodal marginal zone lymphoma

17

What are the symptoms of extra-nodal marginal zone lymphoma?

Epigastric pain, ulceration and bleeding

18

How aggressive is enteropathy-associated non-hodgkin's lymphoma?

Very aggressive

19

What is the main association of enteropathy-associated non-hodgkin's lymphoma?

Coeliac

20

What finding on a blood film is typial of CLL?

Smear/ smudge cells

21

Recall the surface markers of intermediate B cells vs mature B cells vs CLL mature B cells

Intermediate B cell: CD5 positive
Mature B cell: CD19 positive
Mature CLL B cell: CD5 positive and CD19 positive

22

What are the 2 staging methods that can be used in CLL?

Rai staging
Binet staging

23

Is CLL a pre- or post-germinal centre malignancy?

50% pre, 50% post

24

How can pre- and post-germinal centre CLL be differentiated?

VDJ sequencing

25

Which mutation is associated with a particularly poor prognosis in CLL?

17p deletion (TP53)

26

What is Richter's syndrome?

Rare transformation of CLL to high grade lymphoma

27

Recall 3 classes of targeted therapy that can be given to treat CLL

1. BCR kinase inhibitors (eg ibrutinib and idelalisib)
2. BCL2 inhibitors (eg venetoclax)
3. CAR-T and other experimental cell-based therapies

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