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Oncology Exam 3 > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

Proliferation of what 2 cells can cause non-hodgkins lymphoma?

A
  1. T cells
  2. B cells
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2
Q

What is the median age for lymphoma diagnosis?

A

56

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3
Q

What patient population is lymphoma most common in?

A

White males

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4
Q

What are 3 risk factors for lymphoma? (First slide)

A
  1. Genetic immunodeficiency
  2. Immunosuppression (acquired or chronic)
  3. Autoimmune diseases
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5
Q

What are 3 risk factors for lymphoma? (Second slide)

A
  1. Infection
  2. Radiation
  3. Chemicals
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6
Q

What 4 infections can cause lymphomas?

A
  1. Epstein Barr virus
  2. Human T cell lymphotroptic virus type 1
  3. Kaposis sarcoma
  4. Helicobacter pylori
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7
Q

What are the 3 types of lymphomas?

A
  1. Indolent
  2. Aggressive
  3. Highly aggressive
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8
Q

What are 2 sites of involvement that can help determine the clinical presentation of lymphomas?

A
  1. Lymph nodes
  2. Bone marrow
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9
Q

What is the most important factor for prognosis of NHL?

A

Subtype

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10
Q

What are the 5 criteria’s for prognosis?

A
  1. Subtype
  2. Stage
  3. Performance status
  4. Tumor burden
  5. International prognostic index (IPI)
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11
Q

Slow growing disease with ‘favorable’ survival rates

A

Indolent

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12
Q

True or False: indolent lymphomas are incurable with standard therapies

A

True

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13
Q

What are 2 pharmacological treatments that are used for indolent lymphomas?

A
  1. Rituximab + Bendamustine
  2. Rituximab only
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14
Q

What is the MOA of Rituximab?

A

Anti-CD20 monoclonal antibody

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15
Q

What are 2 main ADRs shown with Rituximab?

A
  1. Infusion site reactions
  2. Reactivate latent infections
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16
Q

Fast growing disease with high cell turnover

A

Aggressive lymphoma

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17
Q

True or False: Aggressive lymphomas are incurable

A

False (potentially curable)

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18
Q

What is the standard regimen for aggressive lymphomas?

A

RCHOP

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19
Q

What does RCHOP stand for?

A
  1. Rituximab
  2. Cyclophosphamide
  3. Doxorubicin
  4. Vincristine
  5. Prednisone
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20
Q

What are 2 other regimens that can be used for aggressive lymphomas?

A
  1. R-CVP
  2. R-EPOCH
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21
Q

How many cycles of R-CHOP do patients get?

A

6-8

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22
Q

What is the main toxicity for vincristine?

A

Peripheral neuropathy

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23
Q

What is the main ADR of doxorubicin?

A

Cardiac toxicity

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24
Q

What drug is not used for relapsed and refractory tumors?

A

Anthracyclines

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25
Q

What are 3 options for treating indolent tumors?

A
  1. Observations
  2. Locoregional radiotherapy
  3. Chemotherapy
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26
Q

What are 3 other treatments, beside chemotherapy, that can be used for relapsed and refractory treatments?

A
  1. Radioimmunotherapy
  2. Bone marrow transplantation
  3. Chimeric antigen receptor T cell (CAR-T)
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27
Q

What protocols are the highly aggressive lymphomas based on?

A

Pediatric

28
Q

What patient population is highly curable for highly aggressive lymphomas?

A

Children

29
Q

What are 2 other regimens that can be used, besides chemotherapy, for highly aggressive lymphomas?

A
  1. CNS prophylaxis
  2. Cranial irradiation
30
Q

What is not considered adequate therapy for highly aggressive lymphoma treatment?

A

R-CHOP

31
Q

When are HIV-associated lymphomas present?

A

With profound B-symptoms

32
Q

What is the median survival for HIV-associated Lymphomas?

A

<12 months

33
Q

What are 3 treatment regimens for HIV-associated lymphomas?

A
  1. Low dose regimens to decrease immune suppression
  2. Concurrent antiretroviral therapy
  3. CNS prophylaxis/ cranial irradiation
34
Q

What kind of age distribution is shown with non-Hodgkins lymphomas?

A

Bimodal

35
Q

What patient population has a higher incidence of Hodgkin’s lymphoma?

A

White males

36
Q

What infection increases the risk of Hodgkin’s lymphoma?

A

Epstein Barr virus

37
Q

True or false: patients with a higher socioeconomic background have a higher risk of developing Hodgkin’s disease

A

True

38
Q

Large bilobate multi nuclear cells that are sometimes referred to as owls eyes

A

Reed-sternberg cells

39
Q

What could reed sternberg cells be a possible fusion of? 3

A
  1. Reticular cells
  2. B cells
  3. T cells
40
Q

Enlarged, painless, rubbery lymph nodes involved in the clinical presentation of Hodgkin’s disease

A

Lymphadenopathy

41
Q

What 3 things are associated with “B” symptoms?

A
  1. Fever >38 C for unknown reasons
  2. Drenching night sweats
  3. Weight loss (unexplained)
42
Q

What are 4 clinical presentations of Hodgkin’s disease?

A
  1. Lymphadenopathy
  2. B symptoms
  3. Alcohol induced lymph node pain
  4. Pruritus
43
Q

True or False: Hodgkin’s disease has a non contiguous spread to adjacent lymph node chains

A

False

44
Q

True or False: Hodgkin’s disease becomes more aggressive over time

A

True

45
Q

What 3 places does Hodgkin’s disease spread?

A
  1. Liver
  2. Bone
  3. Bone marrow
46
Q

What is the most important for Hodgkin’s disease prognosis?

A

Stage

47
Q

The presence of b symptoms has a ______ prognosis

A

Poorer

48
Q

What gender has a poorer prognosis with Hodgkin’s disease?

A

Males

49
Q

True or false: Younger patients have a poorer prognosis in Hodgkin’s disease

A

False (older)

50
Q

What are 3 treatment options for Hodgkin’s disease?

A
  1. Radiation
  2. Chemotherapy
  3. Combination of radiation and chemotherapy
51
Q

What chemotherapy regimen is used for Hodgkin’s disease?

A

ABVD

52
Q

What drugs are involved in ABVD?

A
  1. Doxorubicin
  2. Bleomycin
  3. Vinblastine
  4. Dacarbazine
53
Q

For early favorable Hodgkin’s disease how many cycles of ABVD are needed?

A

2-4 cycles

54
Q

For early unfavorable Hodgkin’s disease, how many cycles of ABVD are needed?

A

4-6 cycles

55
Q

For early favorable Hodgkin’s disease what regimen is used?

A

ABVD + XRT

56
Q

For early unfavorable Hodgkin’s disease, what regimen is used?

A

ABVD + XRT

57
Q

For advanced favorable Hodgkin’s disease, what regimen is used?

A

ABVD only

58
Q

For advanced favorable Hodgkin’s disease, how many cycles of ABVD are needed?

A

6-8 cycles

59
Q

For advanced unfavorable Hodgkin’s disease, what regimen is used?

A

ABVD only

60
Q

For advanced unfavorable Hodgkin’s disease, how many cycles of ABVD is needed?

A

6-8

61
Q

What is an irreversible ADR of bleomycin?

A

Pulmonary fibrosis

62
Q

What is the main ADR seen with vinblastine?

A

Peripheral neuropathy

63
Q

What is needed when monitoring for Dacarbazine?

A

An echocardiogram

64
Q

What drug can be used for refractory or relapsed Hodgkin’s disease?

A

Brentuximab vedotin

65
Q

What is the pattern of spread for non Hodgkin’s lymphoma?

A

Non contiguous

Oncology Exam 3 (6 decks)

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