Flashcards in Lymphoma and Myeloma Deck (11):
How does Hodgkin's Lymphoma present?
- Bomidal age incidence (20s-30s and 70s)
- Painless lymphadenopathy spreading from one nodal group to adjacent nodes
- Haematogenous spread to liver, lungs and bone marrow
- May have B symptoms (unexplained fever, night sweats, weight loss)
- Sometimes generalised pruritis or alcohol induced lymph node pain
How does diffuse large B cell lymphoma (Non-Hodgkin's) present?
- Usually >60yrs
- Painless lymphadenopathy, hepatosplenomegaly, extranodal presentation and systemic upset
How is diffuse large B cell lymphoma (Non-Hodgkin's) treated?
How does follicular lymphoma (Non-Hodgkin's) present?
- Associated with t14:18 translocation
- Asymptomatic lymph node enlargement
- Hepatosplenemegaly and B symptoms
How is follicular lymphoma (Non-Hodgkin's) treated?
- CD20 is an antigen expressed on B-lymphocytes and is the target for treatment with the monoclonal antibody Rituximab
How are lymphoma's staged?
- Ann Arbor Staging System
- A/B = absence/presence of B symptoms
- Stage 1 = single LN region
- Stage 2 = ≥2 LN areas, same side of diaphragm
- Stage 3 = LN areas on both sides of diaphragm
- Stage 4 = extensive disease (liver, bone marrow)
How is Hodgkin's lymphoma treated?
- Adrimycin (cardiotoxic)
- Bleomycin (pulmonary toxic)
How is multiple myeloma diagnosed?
- Symptoms include backache, fatigue, symptoms of hypercalcaemia, recurrent infections and renal impairment
- Myeloma is typified by ↑ plasma cells in bone marrow, clonal IG or paraprotein and lytic bone lesions
- FBC (NN anaemia), ↓WCC and platelets, ↑ESR, ↑Ca, SFLC quantification, SPE expression and urine for Bence-Jones protein
What is the pathophysiology of multiple myeloma?
- Abnormal plasma cells produce an abnormal monoclonal protein called a paraprotein or 'M' protein
- There are 5 subtypes (IgG, IgA, IgM, IgD and IgE)
How is myeloma treated?
- Depends on CRAB features
- Calcium elevation
- Renal dysfunction
- Bone disease
- Chemotherapy, radiotherapy and BMT