Nikcevich- CLL Cases Flashcards Preview

IHO Week 4 > Nikcevich- CLL Cases > Flashcards

Flashcards in Nikcevich- CLL Cases Deck (27):
1

What is the most common leukemia in adults? What is the median age of diagnosis and survival?

Chronic lymphocytic leukemia

65

9 yrs

2

What is the only curative therapy for CLL?

allogenic stem cell transplant

3

What is CLL?

Uncontrolled clonal accumulation of mature lymphocytes

assoicated w/ mutated IgVh genes

4

If you were using flow cytometry to diagnose a case of CLL what CD markers would you be looking for?

CD5
CD19
CD20
CD23

5

What CDs are associated w/ mantle cell lymphoma?

CD5
CD23
cyclin D

6

What is a DDX for CLL?

Follicular lymphoma
mantle cell lymphoma (distinguished by CD)
Prolymphocytic leukemia
SLVL
HCL

7

CLL is often an _________dx in a _______pt.

incidental
asymptomatic pt

8

Progressive adenopathy and bone marrow involvement correlates with what sxs in CLL?

fatigue, malaie, weight loss, fevers

Severe cytopenias, increased risk of infection

9

What are the long term complicatoins of CLL?

Autoimmne sequelae

Richter's transformation

10

What autoimmune complications are associated w/ CLL?

AIHA
Pure red cell aplasia
ITP
Neutropenia

11

What are the Rai system stages?

0-lymphocytosis
1-lymphadenopathy
2- splenomegaly
3- HgB < 11
4- platelets < 100K

12

What are the Binet system stages?

A- lymphocytosis and 1-3 sites lymphadenopathy
B- lymphocytosis w/ >3 sites lymphadenopathy
C- lymhphocytois + anemia/thrombocytosis

13

What is the median survival for CLL?

>10 years

14

What are poor prognostic factors for CLL?

Advanced stage at dx
Rapid lymphocyte doubling time
diffuse marrow infiltration
advanced age/M
Elevated b2 microglobulin, soluble CD23

15

What CD is associated w/ poor prognosis?

CD23
ZAP 70

16

What are cytogenetic abnormalities are associated w/ CLL?

13q
Trisoy 12
11q
17p

**ALWAYS get FISH studies w/ CLL

17

CD38 can be a surrogate marker for Ig gene mutations. You can detect via flow cytometry!
CD38+ and CD38- are associated w/ what prognosis? survival?

CD38+ unmutated Ig gene mutations= poor prognosis (9 year survival)

CD38- mutated Ig genes= better prognosis (>20 yrs survival)

18

ZAP 70 expression correlates w/ what CD expression/prognosis?

CD38 expression
POOR prognosis

**correlates w/ IgVh gene mutations

19

When should you treat CLL?

When there is progressive lymphocytosis, lymphadenopathy, splenomegaly, obne marrow failure

20

What are the tx options for CLL?

Corticosteroids
Alkylating agents

21

What nucleoside analogs can be used to tx CLL?

FLudarabine
Pentostatin

22

What monoclonal antibodies can be used to tx CLL?

Rituximab (anti-CD20)
Ofatumumuab (anti-CD 20)

23

What combination chemo is used to tx CLL?

PCR
FCR

24

How do you treat younger pts w/ CLL?

Clinical trial
PCR/FCR
Bendamustine plus rituximab
Ibrutinib

25

How do you treat older, more frail pts?

Chlorambucil +/- prednisone
Bendamustine plus rituximab
Ibrutinib

26

What is the only curative modality for CLL?

allogenic transplant
need matched-sib donor
substantial morbidity/mortality

27

What is the price of curing CLL?

GVHD