Lymphoma and Myeloma Flashcards Preview

Haematology (Phase 3) > Lymphoma and Myeloma > Flashcards

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?

- Rituximab
- Cyclophosphamide
- Adriamucin
- Vincristine
- Prednisolone


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)
- Vinblastine
- Dacarbazine


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
- Anaemia
- Bone disease
- Chemotherapy, radiotherapy and BMT


How does MGUS differ from myeloma?

- <10% marrow plasma cells
- IgG <20g/l and IgM <10g/l in serum
- No CRAB features