Hodgkin's Lymphoma Flashcards Preview

Hematology-Oncology Exam 2 > Hodgkin's Lymphoma > Flashcards

Flashcards in Hodgkin's Lymphoma Deck (29):
1

why is the Ann Arbor Staging important in HL

bc it spreads continguously

2

what is the malignant hallmark for HL

Reed-Sternberg cells

3

describe the clinical behavior of HL

very heterogenous
indolent to fulminant disease

4

is HL curable?

yes - 80%
can irradiate the suckers

5

which HL has the best prognosis?

lymphnocyte predominant
10+ years median survival

6

whcih is the worst prognosis?

lymphocyte depleted
0.3 years median survival

7

is the etiology known?

nope

8

which virus is associated with HL

EBV about 50%

9

What does HL cause in advanced stage

depression of cell mediated immunity

10

At what age does HL occur?

bi-modal age distribution
first peak - 20
second peak - .60

11

What other disease is bi-modal age distribution seen in?
I dk if this is correct!

ALL --> peds is most common
usually peaks early then theres a steady incline into adulthood

12

what is most common presentation of Hodgkins Disease (HD)

painless enlargement of cervical and/or supraclavicular LN

13

What can be detected using a chest xray

anterior mediastinal mass

14

what are the systemic symptoms of HD

unexplained fevers, drenching night sweats, weight loss > 10% body weight

15

what is considered a risk factor for HD

age and the stage they are in

16

What are the disease characteristics of HD

UNIFOCAL in origin
Predictable spread - adjacent lymph nodes

17

What are the disease characteristic exceptions of HD

1. retrograde spread from cervical to retroperitoneal LN --> via the thoracic duct
2. spleen --> liver
3. vascular invasion is rare

18

How do you diagnose HD?

biopsy of invovled tissue
-especially at relapse

-knowing the hx of LN in HL is important bc you need to know if its a residual/scar tissue and not new

19

if HL is limited disease, what treatment method do you use?

radiation therapy

20

if Hl is widespread/extranodal invovlement, treatment?

systemic chemo

21

anatomical staging is important in HL bc?

critical for making treatment decisions and it defines the limits of the disease

22

What is the Ann Arbor Staging?

I Single lymph node (LN region (I) or a single extranodal (localized) organ or site (IE)

II Two ore more lymph nodes on the same side of the diaphram (II) or localized involvement of an extralymphatic organ or site of the diaphragm (IIE)

III Lymph node regions on both sides of the diaphragm (III) which may also involve the spleen (IIS) or local involvement of an extralymphatic organ or site(IIIE) or both (IIISE)

IV Diffuse or disseminated involvement or one or more extralymphatic organs without associated lymph node involvement

23

What was the historical treatment for HL

MOPP
M - Mechlorethamine
O - Oncovin (Vincristine)
P - Procarbazine
P - Prednisone

24

What is the treatment regimen used now

ABVD
A - Adriamycin
B - Bleomycin
V - Vinblastine
D - Dacarbazine

25

What is the trend in HL treatment?

to get away from chemo

26

what are the reasons why ABVD is better than MOPP

MOPP is very leukemagenic – can cause leukemia in the long term
MOPP causes sterility

ABVD does the opposite of MOPP

27

What do you do for recurrent HL

Post XRT almost always just outside of radiation field

Post chemotherapy are systemic and are best treated with high-dose therapy and autologous PBSCT

**ADC – Brentuximab vedotin

With extensive disease and bone marrow involvement, allogeneic or MUD BMT is preferred

Lymphocyte Predom – Role of rituximab

28

What cell does ADC target

CD30+

29

What is Brentuximab vedotin MOA?

bind with CD30+ on HL cell surface --> then forms a complex with CD30 and enters into the cell --> once inside, ADC chemo component is relased and kills the cancer cell