NHL - cell of origin - age - lymphnodes - BM - tx (y/n)

- B cell (T/NK) - 60-70 y/o - any nodes - often BM - tx: yes

HL - cell of origin - age - lymphnodes - BM - tx (y/n)

- B cell - bimodal - sequential - often BM - tx: yes

Chronic Lymphocytic Leukemia - cell of origin - age - lymphnodes - BM - tx (y/n)

- B cell - 60s-70s - any nodes - BM - tx: yes

Multiple Myeloma - cell of origin - age - lymphnodes - BM - tx (y/n)

- B cell - 60s-70s - Rarely nodes - BM - tx: yes

- 5th leading cancer dx - most comm hematological cancer - 85% cells=B cell origin - incidence more than doubled since 70s

- follicular - marginal zone - SLL - lymphoplasmacytic lymphoma

- diffuse large B-cell - mantle cell - peripheral t-cell lymphoma - primary mediastinal large B-cell lymphoma - anaplastic large cell lymphoma - lymphoblastic lymphoma - Burkitt's

NHL, HL Flashcards by Alegra Mendez

mature lymphoid malignancies

NHL
HL
Chronic Lymphocytic Leukemia
Multiple Myeloma

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typically lymphomas don’t circulate in blood in significant numbers except

CLL

SLL

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NHL

cell of origin
age
lymphnodes
BM
tx (y/n)

B cell (T/NK)
60-70 y/o
any nodes
often BM
tx: yes

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cell of origin
age
lymphnodes
BM
tx (y/n)

B cell
bimodal
sequential
often BM
tx: yes

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Chronic Lymphocytic Leukemia

cell of origin
age
lymphnodes
BM
tx (y/n)

B cell
60s-70s
any nodes
BM
tx: yes

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Multiple Myeloma

cell of origin
age
lymphnodes
BM
tx (y/n)

B cell
60s-70s
Rarely nodes
BM
tx: yes

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NHL epidemiology

5th leading cancer dx
most comm hematological cancer
85% cells=B cell origin
incidence more than doubled since 70s

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NHL

presentation

local
-swollen nodes
-pain (compression/infiltration)
-organ failure/compromise 
systemic
-fevers, night sweats, weight loss, fatigue

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indolent NHL

follicular*
marginal zone
SLL
lymphoplasmacytic lymphoma

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aggressive NHL

diffuse large B-cell*
mantle cell
peripheral t-cell lymphoma
primary mediastinal large B-cell lymphoma
anaplastic large cell lymphoma
lymphoblastic lymphoma
Burkitt’s

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T cell surface antigens

CD2
CD3
CD4
CD8

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B cell surface antigens

CD19
CD20
CD22
CD79a

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NHL staging

I-single lymph node
II-2+ nodes, same side of diaphragm
III- 2+ nodes, different sides of diaphragm
IV- extra nodal disease (BM)

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international prognostic index (for Non-Hodgkin’s lymphoma)

1 pt for each risk factor:

age
performance status
LDH 
extranodal sites
Stage

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NHL that initially responds to chemo, but ultimately recurs (not cured)

indolent

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NHL with potentially profound response to chemo, ultimately curable

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aggressive

NHL tx

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surgery has NO significant role
radiation
chemo

classes of chemo generally used in NHL

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alkylators
anthracylines
steroids

indolent NHL tx

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QOL tx

rituximab

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monoclonal CD20 Ab

antibody-dependent cellular cytotoxicity (ADCC)

complement-dependent cytotoxicity (CDC)

apoptosis

NHL chemo combo

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CHOP

cyclophosphamide
doxorubicin
vincristine
prednisone

HIV-associated lymphoma

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vast majority=aggressive

B cell origin
CD4 <200
high viral load/advanced disease
tx w/ HAART –> dec risk

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unusual variant of B-cell lymphoma (~15%)

adenopathy (progressive)

neck/mediatinum
sx: night sweats/fevers/weight loss, “pel-ebstein” fevers, pruritus, EtOH
typically slow, orderly growth
tx outcomes for early stage disease = excellent

HL age distribution

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bimodal, 20s or 60s

nivolumab

targets PD-1 on T-cells (a suppressor of immune function) binds and INactivates this unleashes T cells that recognize Reed-Sternberg cells HL tx

half of HL cases contain ____ DNA in Reed-Sternberg cells

EBV

reed sterberg cellClas

multinucleate giant cells derived from malignant B lymphocytes CD30, CD15 IgH rearrangement monoclonal seen in classical HL (from mature B cells at germinal center)

CD30, CD15

Reed Sternberg cell

HL staging

I-single lymphoid chain II-2 chains on one side of diaphragm III-above and below diaphragm IV-diffuse non-lymphoid spread also A-absense of constitutional sx B-presence of (F/NS/>10%weight loss) M-bulky mediastinal mass E-involvement of extra nodal site

classical HL

4 subtypes - nodular sclerosis - mixed cellularity - lymphocyte rich - lymphocyte poor

non-classic HL

1 subtypes

HL tx goals

aimed at cute, start ASAP

HL standard chemotherapy

ABVD adriamycin bleomycin vinblastin dacarbizine

HL early stage tx

radiation alone chemo +radiation just to site of involvement or chemo alone

surveillance of HL survivors

- mammograms starting at 30 or 8-10 yrs from XRT | - colonoscopy 8-10 yrs post XRT

Brentuximab

fusion chemo-immunoconjugate combining a monoclonal Ab against CD30 and an MT inhibitor *RS cells =CD30

NHL, HL Flashcards

(36 cards)