New advances in Treatment for blood cancers

Question 1

How does chemo work?

Answer 1

damages DNA of cancer cells in mitosis causing cell to undergo apoptosis

Question 2

what protein is usually invovled in apoptosis?

Answer 2

p53

Question 3

Why do lymphomas and leukaemias respond better to chemo than other cancers?

Answer 3

lymphocytes are keen to undergo apoptosis in the normal lymph node

Question 4

What is a PET scan?

Answer 4

in ject radio-labelled glucose and then through the gamma camera

Question 5

How do monoclonal antibodies work?

Answer 5

immune treatment that affects only cells which possess target protein

Question 6

What si the action of rituximab?

Answer 6

naked antibody that binds to CD20 on B cells- found on all B cell lymphomas

Question 7

What is the problem with rituximab?

Answer 7

relies on bodys immune system to kill malignant cells once tagged

Question 8

How does Brentiuximab Vedotin work?

Answer 8

chemo drug conjugated to CD30 antibody

Question 9

CD30 is found on what type of lymphomas?

Answer 9

Hodgkins cells and some T cell NHL

Question 10

What is bioogical treatments?

Answer 10

dont affect cells as they divide- not chemo and arent targeted to malignant cells

Question 11

What are examples of biological treatments?

Answer 11

proteosome inhibitors and IMIDs

Question 12

What haem malignancy are biological treatments mainly used in?

Answer 12

multiple myleom

Question 13

What is the proteosome?

Answer 13

dustbin for old proteins in cells to recycle amino acids

Question 14

What does blockade of the proteosome cause?

Answer 14

accumulation of toxic proteins inside the cell causing apoptosis

Question 15

What are the main SE of proteosome inhibitors?

Answer 15

nerve damage and low platelets

Question 16

What are IMIDs derivatives of?

Answer 16

thalildomide

Question 17

What type of cancer are tyrosine kinase inhibitors used in?

Answer 17

chronic myeloid leukaemia

Question 18

What are the phases of untreated chronic myeloid leukaemia?

Answer 18

chronic phase (lots of immaure white cells in blood)—acclerated phase—blast crisis(transformed to acute leukaemia)

Question 19

What is the cause of chronic myeloid leukaemia?

Answer 19

chromosomal translcation T(9:22) which creates a new oncogene

Question 20

what is the name of the chromosomal translcation T(9:22)

Answer 20

philidelphia

Question 21

What is the name of hte oncogene created by the philidelphia chromosome?

Answer 21

BCR-ABL

Question 22

What is the normal function of a tyrosine kinase enzyme?

Answer 22

switches on proteins by phosphorylation

Question 23

What drug targets the tyrosine kinase action of BCR-ABL?

Answer 23

imatinib by taking place of ATP in BCR-ABL molecule

Question 24

What are the SE of tyrosine kinase inhibitors?

Answer 24

diarrhoea; fluid in lung; neutropenia

Question 25

What happens in B cell receptors dont receive stimulation by antigen?

Answer 25

undergo apoptosis

Question 26

What is the problem in CLL and lymphoma cells that causes them to avoid apoptosis?

Answer 26

abnormally active signalling mechanisms inside cell

Question 27

What are drugs affecting B cell signalling pathways?

Answer 27

ibrutinib; idelalisib

Question 28

When is idelalisib used?

Answer 28

CLL with p53 mutation- dont respond to chemo

Question 29

What are the side effects of ibrutinib?

Answer 29

fever; low platelets; anaemia; SOB

Question 30

What are the side effects of idelalisib?

Answer 30

diarrhoea; rash; fatigue; liver abnormality; fever

Question 31

What is the problem with the immune response in Hodgkins?

Answer 31

Reed Sternberg cells cause immune reaction, but cells are unable to kill the malignant cells: immune evasion

Question 32

How do Hodgkins cells avoid the immune system?

Answer 32

produce proteins that bind to PD1 receptors on T cells

Question 33

What is the purpose of PD1 receptors on T cells?

Answer 33

tells T cell that it is a host cell and not to kill

Question 34

What is the MOA of nivolumab?

Answer 34

sticks to the chemical produced by the cancer cell and stops it binding to the effector cell allowing attack of the cancer cell

Question 35

What type of agen in nivolumab?

Answer 35

checkpointi nhibitor

Question 36

What type of therapy is allogenic bone marrow transplant?

Answer 36

immune therapy

Question 37

Why is bone marrow transplant an immune therapy?

Answer 37

T cell from donor are also given to attack the cancer cells : gradt vs leukaemia or lymphoma

Question 38

What is the problem with graft vs leukaemia/lymphoma?

Answer 38

also graft vs host disease

Question 39

What is adoptive immunotherapy?

Answer 39

make patients own immune cells recognise cancer as foreign and attack

Question 40

What is hte most promising development in adoptive immunotherapy?

Answer 40

CAR t cell therapy (chimeric antigen receptor T cells)

Question 41

How does CAR T cell therapy work?

Answer 41

use retroviruses to create cell surface receptor specific to eg CD19 to target cancer cell