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ABIM Hematology > NHL > Flashcards

NHL Flashcards

1
Q

Indications to treat follicular lymphoma stage III or IV?

A
  1. clinical trial
  2. symptoms
  3. end organ damage imminent
  4. cytopenia that are 5. significant or progressing
  5. bulky disease
  6. rapid progression
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2
Q

Is auto HSCT an option in 1st remission for follicular lymphoma?

A

no

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3
Q

In FL, what treatment would you use if pt was given 1L rituxan and had remission for >6mo?

A

retreatment with rituxan

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4
Q

how do you treat grade 3b FL (defined as >15 centroblasts with solid sheets of centroblasts)

A

as DLBCL; RCHOP

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5
Q

Maintenance therapy for FL for pts who present with high tumor burden?

A

Rituximab q2-3mo for 2 years

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6
Q

Tx for R/R FL that targets EZH2?

A

tazemetostat (methyltransferase inh)

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7
Q

MALT lymphoma that is H. pylori positive that carry this mutation are resistant to H. pylori -directed ABx.

A

t(11;18). need to add ISRT

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8
Q

Splenic MZL is associated with which virus?

A

Hep C

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9
Q

SMZL immunophenotype?

A

CD20+, CD22+, negative for CD5, CD10 and cyclin D1. lacks CD25 and CD103 which are positive in hairy cell leuk

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10
Q

Tx SMZL?

A

splenectomy or Rituxan. treat Hep C if positive as this may cause lymphoma to regress

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11
Q

low intensity regimens for mantle cell lymphoma?

A

BR
R-CHOP
VR-CAP
R2
BR + Cytarabine

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12
Q

ibrutunib dose in mantle cell lymphoma?

A

560mg PO daily

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13
Q

Aggressive treatment regimen for mantle cell should include?

A

cytarabine

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14
Q

high risk scenarios for CNS relapse in DLBCL?

A
  1. high CNS IPI score
  2. testicular lymphoma
  3. double or triple hit
    primary cutaneous DLBCL, leg type
  4. stage IE DLBCL of breast
  5. kidney or adrenal involvement
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15
Q

Treatment approach for nasal NK/T-cell lymphomas?

A

chemo RT. all regimens contain asparaginase

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16
Q

virus associated with PEL?

A

HHV-8

17
Q

PEL affects which body cavities? Tx?

A

pleural, pericardium and peritoneum; R-EPOCH

18
Q

+S100, +CD163, +CD68
CD1a- ; CD207-

A

Rosai Dorfman Disease

19
Q

Tx for Rosai Dorfman Disease? localized disease?

A

First observe as 80% spontaneously improve; surgery; multifocal disease treated with COBIMETINIB, cladribine, cytarabine, MTX, or prednisone

20
Q

treatment approach for T-PLL? (T-prolymphocytic leuk)

A

alemtuzumab-based therapy

21
Q

breast-implant associated lymphoma?

A

anaplastic large-cell lymphoma (7-9 years after implant)

22
Q

Do plasmablastic lymphomas express CD20? Virus association?

A

No; HIV – treat with EPOCH and IT chemo

23
Q

preferred tx for ALCL ALK+? Second line?

A

BV-CHP; alectinib or crizotinib

24
Q

Ppx needed for polatuzumab?

A

PCP and herpes ppx

25
Q

Immunohistochemical signature of Primary Mediastinal BCL?

A

Positive for B-cell markers (CD19, 20, 22, 79a), CD45, CD200, CD23, and MAL

Neg for CD5 and CD10.

26
Q

Define bulky disease in DLBCL?

A

lymph node mass > 7.5cm

27
Q

Tx limited stage (I or II) non-bulky DLBCL?

A

RCHOP x3 +RT
or
RCHOP x4

28
Q

Tx limited stage (I or II) bulky DLBCL?

A

RCHOP x6 +/- RT

29
Q

Do you give maintenance in Burkitt’s lymphoma? CNS ppx?

A

No; yes

30
Q

Castleman’s disease aka giant lymph node hyperplasia is defined as active when:

A
  1. fever
  2. increase serum CRP >20
  3. 3 of the following symptoms: LAD, large spleen, edema, effusion, ascites, cough, nasal obstruction, xerostomia, rash, central neurologic symptoms, jaundice, AIHA
31
Q

Treatment for pulmonary lymphomatoid granulomatosis (PLG)?

A

Asymptomatic: withdraw implicated medication (azathioprine, methotraxate, etc) and observe

Symptomatic: RCHOP

32
Q

Tx backbone for T-PLL (t-cell prolymphocytic leukemia)?

A

Alemtuzumab ((binds CD52)

33
Q

compare IHC of Mantle cell vs CLL/SLL vs FL?

A

Mantle and CLL both CD5 positive but CLL typically CD23+ and C20+ while Mantle typically CD23-. Mantle is FMC7+ while CLL is FMC7-.

FL is CD10+

34
Q

MALT lymphoma of skin assoc with which bug?

A

borrelia burgdorferi

35
Q

Most common marker that represents indolent mantle cell lymphoma?

A

SOX11 neg / IGHV mutated

36
Q
A

ABIM Hematology (4 decks)

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