lymphoproliferative disorders Flashcards
(23 cards)
What is leukaemia
Used to describe a cancer that is seen in the blood
What are lymphomas
Cancers of lymphoid origin
What is the presentation of a lymphoma
- Enlarged lymph node - lymphadenopathy
- Extranodal involvement
- Bone marrow involvement
- Systemic symptos - weight loss, fever, night sweats, pruritis and fatigue
how are lymphomas diagnosed
lymph node biopsy
What is acute lymphoblastic leukaemia
Canerous disorder of the lymphoid progenitor cells - immature - no differentiation but instead rapid growth and accumulation
Who does acute lymhoblastic leukaemia usually occur in
Children under 6 years old
What is the usual history that comes with Acute lymphoblastic leukaemia
2-3 week history of bone marrow failure or bone and joint pain
What bloods are seen in acute lymphoblastic leukaemia
- Pancytopenia - severe anaemia
- moderate Thrombocytopenia - moderate low platelets
- Very elevated white cell count
- Blood full with lymphoblast
What is the treatment for acute lymphobastic leukaemia
- Induction chemotherapy to obtain remission
- Consolidation therapy
- CNS directed treatment
- Maintenence treatment for 18 months
- Stem cell transplant if very severe
What is required for the diagnosis of chronic lymphocitic leukaemia
Lymphocyte count > 5
What is the presentation of chronic lymphocytic leukaemia
- bone marrow failure (anaemia and thrombocytopenia)
- Lymphadenopathy
- Splenomegaly
- Fever
- Night sweats
less common: - Infections
- Weight loss
- Hepatomegaly
What is stage A chronic lymphocytic leukaemia in the BINET scale
less than 3 lymph node areas
What is stage B in Binet scale for chronic lymphocytic leukaemia
3 or more lymph node affected
What is stage C of chronic lymphocytic leukaemia in the Binet scale
Stage B + anaemia or thrombocytopenia
What is the indication for treatment in chronic lymphocytic leukaemia
- Progressive bone marrow failure
- Massive lymphadenopathy
- Progressive splenomegaly
- Systemic symptoms
- Autoimmune cytopenias
- Lymphocyte doubling time <6 months
What is the treatment of chronic lymphocytic leukaemia
- Usually no treatment due to low grade leukaemia
- Cytoxic chemotherapy - fludarabine and bendamustine
- Monoclonal antibodies - rituximab and obinatuzumab
What is the presentation of a lymphoma
- Lymphadenopathy
- Hepatosplenomegaly
- Extranodal disease
- Bone marrow involvement
What is the difference between a low grade and high grade lymphoma
-Low grade are slow while high grade are agressive and fast growing
High grade is curable with combination chemotherapy but low grade is incurable
What is the commonest high grade lymphoma
Diffuse large B-cell lymphoma
What is the treatment for non-hodgkin lymphoma
Combination chemotherapy - typical anti-CD20 monoclonal antibody + chemo
describe the bimodal age curve in hodkin lymphoma
1st peak 15-35
2nd peak later in life
What is hodkin lymphoma associated with
Eppstein bar virus
What is the treatment for hodkin lymphoma
- Combinastion chemotherapy with or without radiotherapy
- Monoclonal antibodies
(anti-CD30)
Immunotherapy
