Lymphoma II

Question 1

What are the ages of Hodgkin’s lymphoma?

Answer 1

20-30, then >50

Question 2

Who gets hodgkin’s lymphoma?

Answer 2

Male caucasians

Question 3

What is the survival rate of Hodgkin’s disease?

Answer 3

85%

Question 4

What are the two associated infectious agents with Hodgkin’s lymphoma?

Answer 4

EBV and HIV

Question 5

What are the ssx of Hodgkin’s disease?

Answer 5

fevers/chills/night sweats/weight loss
Pruritis
EtOH induced pain in lymph nodes

Question 6

What are the common areas of lymphadenopathy of Hodgkin’s disease?

Answer 6

70% cervical

60% mediastinal

Question 7

What is the major difference in lymphadenopathy between Hodgkin’s and NHL?

Answer 7

Contiguous in HL

Question 8

True or false: unilateral bone marrow biopsy for HL is sufficient

Answer 8

True

Question 9

What is stage I HD?

Answer 9

1 nodal region or lymph node

Question 10

What is stage II HD?

Answer 10

2 or more nodal regions on the same side of diaphragm

Question 11

What is stage III HD?

Answer 11

Both sides of the diaphragm

Question 12

What is stage IV HD?

Answer 12

> 1 extranodal sites

Question 13

What is a Reed Sternberg cell?

Answer 13

B cell origin with multinuclei (owl eyes)

Question 14

What are the two CD markers for HD?

Answer 14

CD15 and CD30

Question 15

What are the markers for adverse prognostic factor for HD?

Answer 15

Albumin 15

Hb

Question 16

What is the prognosis for HL disease?

Answer 16

Very good

Question 17

What are the treatments for HD?

Answer 17

Chemo + XRT. One alone if low grade, both if advanced

Question 18

Which is more common: NHL or HL?

Answer 18

NHL

Question 19

Who is usually affected by NHL?

Answer 19

Adult, white men

Question 20

What are the two types of NHL?

Answer 20

B cell (85%) and T cell (15%)

Question 21

What is the 5 year survival for NHL?

Answer 21

67%

Question 22

What are the infectious agents that are implicated with NHL?

Answer 22

EBV
HTLV-1
HCV
HHV8
H.pylori

Question 23

What are the occupations/exposures of NHL? (3)

Answer 23

Agriculture
Benzene exposure
Prior Chemo/radiation

Question 24

What are the ssx of NHL?

Answer 24

b-sx, but more symptoms if aggressive

Question 25

When is an LP indicated for NHL?

Answer 25

testicular, nasopharyngeal involvement

Question 26

What is the translocation for follicular lymphoma? Oncogene?

Answer 26

t(14;18) | bcl-2

Question 27

What is the translocation for SLL? Oncogene?

Answer 27

t(14;19) | bcl3

Question 28

What is the translocation for mantle cell lymphoma? Oncogene?

Answer 28

t(11;14) | bcl1

Question 29

What is the translocation for burkitt's lymphoma? Oncogene?

Answer 29

t(8;14) | myc

Question 30

What is the translocation for DLCL? Oncogene?

Answer 30

t(3;14) | bcl6

Question 31

What are the two very aggressive NHLs?

Answer 31

Burkitt's | Any T cell

Question 32

What is diffuse large cell lymphomas?

Answer 32

Rapidly enlarging mass with extranodal sites

Question 33

What is the overall cure rate of diffuse large cell lymphoma?

Answer 33

45%

Question 34

What are the prognostic factors for diffuse large cell NHL?

Answer 34

LDH elevated Age >60 >1 extranodal site

Question 35

What is the treatment for diffuse large cell NHL?

Answer 35

Chemo + rituxan NOT surgical

Question 36

What is the chemo treatment for DLCL?

Answer 36

Cyclophosphamide Adriamycin Vincristine Prednisone

Question 37

What is the MOA of rituximab?

Answer 37

Anti CD20 ab that targets DLCL

Question 38

What is small lymphocytic lymphoma? (ssx)

Answer 38

Indolent CA with enlarging LN over months to years Usually asymptomatic

Question 39

Who gets SLL?

Answer 39

Late to middle aged

Question 40

What is the prognosis for SLL?

Answer 40

Incurable

Question 41

What is Richter's transformation?

Answer 41

about 35% of follicular lymphomas will transform into DLCL at 10 years of disease

Question 42

What is the treatment for indolent lymphoma, SLL?

Answer 42

Curative radiation therapy if early stages Palliative radiation + chemo if advanced stages

Question 43

What are the three very aggressive NHLs?

Answer 43

Lymphoblastic lymphoma Burkitt's lymphoma Any T cell lymphoma

Question 44

Who usually gets very aggressive NHL?

Answer 44

Peds and young adults

Question 45

What is the prognosis for very aggressive NHLs?

Answer 45

Curable, but very aggressive

Question 46

Who gets a stem cell/BM transplant for aggressive lymphoma? What type of transplant is this?

Answer 46

DLCL, follicular, and very aggressive lymphomas Autologous stem cells

Question 47

What is MALT lymphoma? Where is this usually found?

Answer 47

Mucosa associated lymphoid tissue lymphoma GI tract, lungs, breasts

Question 48

What is the treatment for MALT d/t h.pylori?

Answer 48

usual treatment for H.pylori Chemo if not spontaneous remission after

Question 49

What are the three HIV associated lymphoma?

Answer 49

DLCL Burkitt's CNS lymphoma

Question 50

Where are HIV associated lymphoma found?

Answer 50

Anus/rectum | Soft tissues

Question 51

What is the major prognosis factor for HIV associated lymphoma?

Answer 51

Low CD4 counts

Question 52

Who gets CLL?

Answer 52

Older pts with immunodeficiency conditions

Question 53

Which type of lymphocyte is associated with CLL?

Answer 53

B cells

Question 54

Where is CLL found in the body?

Answer 54

Always in bone marrow and peripheral blood

Question 55

What are the ssx of CLL?

Answer 55

Asymptomatic to infectious symptoms Lymphadenopathy/splenomegaly

Question 56

What are the labs like i CLL?

Answer 56

Leukocytosis | Low IgG, IgA and IgM

Question 57

What are the CD markers for CLL?

Answer 57

CD5 CD20 CD23

Question 58

What is stage 0 - 4 of CLL?

Answer 58

``` 0 = lymphocytosis 1 = Lymphadenopathy 2 = Splenomegaly 3 = Anemia 4 = thrombocytopenia ```

Question 59

What is the prognosis for CLL? Treatment?

Answer 59

Not curable, but treat with chemo when high stage or very symptomatic