Kebbekus- Lymphoma Cases Flashcards Preview

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Flashcards in Kebbekus- Lymphoma Cases Deck (31):
1

Describe the staging levels of lymphoma.

1- single LN/organ
2->2 LN on same side of diaphragm
3->2 LN above and below diaphragm
4- widespread disease, multiple organs w/ or without LN involvement

2

What are lymph tissues?

Waldeyers ring (tonsils and adenoids)
Spleen

3

What is the treatment for localized (I/II) stage hodgkins?

ABVD x 2
Field radiation

4

What is the treatment for III/IV disease?

ABVD x2
ABVD x2
Intense chemotherapy BEACOPP
Autologous transplant

5

What are the possible late effects of therapy?

Second malignancy
Heart disease
Lung disease
Impaired fertility

6

What second malignancies would you be worried about after therapy for HD?

Solid tumors--lung cancer* and breat cancer
Secondary leukemia

7

Heart disease is an effect of tx for HD because....

it's associated w/ radtation to mediastinum

8

What effect of therapy is associated w/ bleomycin containing regimens that are combined w/ chest radiation?

Lung disease

9

What immunochemistry is associated w/ DLBCL?

Diffuse large b cell lymphoma
CD5-, CD19, CD20, CD23

10

DLBCL is most common in ....

adults

Prototype for an AGGRESSIVE lymphoma

11

DLBCL is often treated w/

CHOP
cyclophosphamide
oncovin= vincristine
prednisone
doxorubicin

12

What do we add to CHOP now that has made a big difference?

Rituximab

13

How long is CHOP given?

18 weeks

14

What is the most common INDOLENT NHL?

Follicular lymphoma

15

What percent of Follicular lymphoma cases are at an advanced stage at presentation?

80%

Often asymptomatic

16

What traaslocation is associated w/ follicular lymphoma?

t(14;18) (q32,a21)

*BCL-2 is translocated to chromosome 14, comes under control of IgH enhancer which leads to overexpression of Bcl-2

BCL-2 chromosome 18q21 inhibits apoptosis

IgH chromosome 14q32

17

What CD marker is associated w/ follicular lymphoma?

CD20

18

What is the cure rate for follicular lymphoma? Survival?

0%

survival 10-12 years

19

What are the indolent B cell lymphomas?

Follicular- most common
CLL/SLL
Marginal Zone
MALT
LPL or waldenstorm

20

What are aggressive BCLs?

DLBCL
Mantle cell** could also be put in indolent column

21

What is a HIGHLY aggressive BCL?

Burkitt

Younger pt
Start chemo right away
associated w/ EBV

22

What translocation is associated w/ mantle cell lymphoma? Associated w/ what cyclin?

t(11,14)
positive for cyclin D1
atypical lymphocytes

Heavy chain on 14 and cyclin D1 translocation

23

Mantle cell lymphoma is positive for what CD?

CD20
CD5

24

How do you treat pts w/ advanced mantle cell?

Induced w/ RCHOP
autologous stem cell transplant

25

What would flow cytometry show for CLL?

Kappa or lambda light chain but NOT both
CD 5, 19, 20, 23

26

Who should be treated for CLL?

For advanced disease if:
BM failure
massive splenogmegaly
massive lymphadenopathy
progressive lymphocytosis over 2 motnhs
AIHA and thromobocytopenia
B symtpoms

27

What CDs are characteristic of MALT lymhoma?

CDD20

28

MALT is frequently associated w/ what bacteria?

H. pylori

29

How do you treat MALT?

2-3 rounds of earadication, if no clearing 203 courses XRT and chemo

30

Post transplant lymphoproliferative disorder is associated w/ what drugs?

Calcineurin inhbitors

Tacrolimus
Cyclosporine

31

What does EBV induced polyclonal expansionof B cells occur?

Suppresson of T cells leads to loss of suppression of B cell prolif.