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Flashcards in NHL Deck (19)
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1
Q

What is the typical translocation of ALCL?

A

t(2;5)(p23:q35)

Leads to constitutional activation of ALK

2
Q

Name 4 common sites of extranodal disease in ALCL

A

Skin, soft tissue, bone, lung

3
Q

What are hallmark cells?

A

Typical cells of ALCL: horseshoe-shaped, eccentric nucleus

4
Q

Name the 3 subtypes of Burkitt lymphoma; state how often it is associated with EBV positivity

A

Sporadic (10-15%)
Endemic (95%)
Related to immunodeficiency (40%)

5
Q

Name the typical translocations associated with Burkitt

A

t(2;8) - Ig K chains
t(8;14) - IgH
t(8;22) - Ig light chains

6
Q

What is the immunophenotype associated with mature B cell lymphoma (Burkitt, DLBCL)?

A

(+)ve: CD19, C20, CD22, CD79a, sIg

(-)ve: CD10, tdT, CD5, CD23

7
Q

What is the outcome of Burkitt lymphoma, both 1) localized and 2) disseminated?

A

1) EFS: 90%, OS 95%

2) EFS: 80%

8
Q

Name 2 novel prognostic risk factors in ALCL

A

1) Anti-ALK antibodies in blood at diagnosis (protector effect)
2) Copy number of NPM-ALK variants in bone marrow at diagnosis (associated with higher relapse rates)

9
Q

Name the 3 histologic variants of DLBCL

A

Centroblastic; immunoblastic; anaplastic

10
Q

Define Group A for localized mature B-cell neoplasm

As per the current standard of care, what is the treatment (group A)?

A

Fully resected Stage I or stage II disease

COPAD * 2

11
Q

When do relapses occur in ALCL?

A

Within 2 years of initial treatment

12
Q

What are the late effects of therapy of NHL treatment?

A

Very rare compared to other cancers
Cardiotoxicity
HCV infections from transfusion (old studies)
Second malignancies (5% at 20y)

13
Q

Risk factors for PTLD in solid organ transplants

A
  • Type of transplant (worse with heart, lung, GI, compared with kidney or liver)
  • EBV negativity in recipient
  • CMV negativity (less consistently reported than EBV)
  • Degree of immunosuppression
14
Q

Risk factors for PTLD in HSCT

A
  • T-cell depleted stem cell source

- Conditioning regimen including antithymocyte globulin

15
Q

Late effects of HD attributable to radiation therapy (7)

A
  • Growth impairment
  • Cardio-vascular disease (coronary artery disease, valvular disease, pericardial disorders)
  • Stroke
  • Infections (splenic radiation)
  • Thyroid dysfunction
  • Infertility
  • Lung fibrosis
  • Second malignancies
16
Q

Late effects of HD attributable to chemotherapy (4)

A
  • Cardiomyopathy (anthracyclines)
  • Lung dysfunction (bleomycin)
  • Male infertility (alkylating agents, procarbazine)
  • Hematologic malignancies (alkylating agents, topoisomerase II inhibitors)
17
Q

Risk factors for anthracycline-related toxicity (4)

A
  • Younger age
  • Female sex
  • Cumulative doses of anthracyclines
  • Combination of mediastinal radiation
18
Q

Risk factors for lung toxicity (3)

A
  • Cumulative doses of toxic agents: bleomycin, BCNU, CCNU
  • Combination of chemotherapy and lung radiation
  • Younger age
19
Q

Name 6 prognostic factors in ALCL

A

Age
Histologic subtype
High MDD
High MRD
Increased copy number variants of ALK in bone marrow at diagnosis
Absence of anti-ALK Ig in peripheral blood at diagnosis