Flashcards in Hubbard - WBC Deck (16)
ATRA is used for?
Methotrexate used for
Maintenance of AML only
Maintenance of ALL
Ommaya reservoir is adventageous when/how?
For leptomeningeal disease, when chemo does not pass through the BBB into the CSF. Better than lumbar puncture.
-Catheter inserted into lateral ventricle for intrathecal therapy.
Symptoms of leukemic meningitis
N/HA due to leptomeningeal infiltration. Use Ommaya reservoir.
For AML, when do you give antibiotics for feveR?
Even if the cause is not found, give broad spectrum.
G-CSF and CM-CSF given for what?
after completion of AML chemo (ATRA?), shortens period of severe myelosuppression.
Leukostasis in CML - s/s; cause, appears during what phases?
-Dyspnea, drwsiness, loss of coordination, confusion
-Caused by leukocyte sludging into pulmonary (lungs)/cerebral vessels.
-Appears during accelerated and blastic phase of CML.
Dx of CML
-Anemia + SM in 30-50%; LUQ fullness and early satiety.
-Leukocytosis with low LAP. Hypercellular bone marrow with myeloid hyperplasia.
Cytogenetics of CML.
When is imatinib used in CML? What type of drug is this?
To decrease development of accelerated or blastic phase.
It is a TKI, first line therapy.
Middle aged white man, + pancytopenia + SM +nonaspirable marrow
Treatment of HCL
1. Mild cytopenia, no infection hx, marrow infiltration low = NO THERAPY
2. First line = ADI
3. Relapses = rituximab
0 = excellent prognosis
3, 4 = anemia an dthrombocytopenia, worse prognosis (have Hb
Clinical manifestations of NHL
Lymphadenopathy +/- compression related presentations (i.e. SVC sydnrome w/distended superficial veins)
-firm and NT
Dx of lymphoma - use what (2)
Staging of lymphoma - use what (1)
-Fine needle aspirate - DO NOT USE
-Excisional Biopsy (preferred for initial diagnosis) --> use Core Needle Biopsy for primary diagnosis (if pt has heart condition/cannot be put under anesthesia)
Burkitt requires what in addition to tx?
CNS prophylaxis + intrathecal chemo or high-dose methotrexate