Flashcards in Week 4: Case studies of leukemia/lymphoma Deck (22):
What are the "B symptoms" of Hodgkin's Lymphoma?
Fever, >10% weight loss, neigh sweats
What should you counsel on with a reproductive-age male before giving chemo therapy?
Why is an excisional biopsy needed for HL diagnosis on not just a fine-needle aspirate?
need to see the architecture
T/F: Hodgkin is not an HIV-related malignancy
False, highly related to HIV
Do males or females get HL?
More males than females
What is the malignant cell of HL?
Reed-Sternberg cell (B-cell)
Does HL jump randomly from lymph node to lymph node?
No, spreads contiguously
What is the standard of care of HL?
ABVD: Adriamycin, bleomycin, vinblastine, dacarbazine. Rituximab is a new treatment
What are the "classical" HL presentations? What are the classic markers present on these cells?
Nodular sclerosis, lymphocyte-rich, mixed cellularity, lymphocyte depleted; CD15, CD30
What marker is typically found on nodular lymphocyte predominant HL?
CD20 (can be targeted by rituximab)
What is the staging for lymphomas?
Ann Arbor staging:
I: Single LN region
II: One side of diaphragm
III: Both side of diaphragm
IV: disseminated throughout body
A: no systemic symptoms
B: fever, night sweats, weight loss
What is the treatment for Stages I and II of HL?
ABVD x 2, involved field radiation
What is the treatment for stages 3 and 4 HL?
ABVD x 2, restage the disease, if it's ok treat with ABVD x4, if refractory switch to BEACOPP and autologous transplant
What are late effects of HL therapy?
second malignancy (Lung and breast), heart disease because of drugs, lung disease, impaired fertility
What labs can you order to look at cell turn over rate?
LDH and uric acid
What are prognostic factors of the IPI scoring system?
Age over 60, Stage III/IV, spending more than 1/2 day resting, elevated LDH, two ore more extranodal sites
What is treatment of non-hodgkin lymphoma?
R-CHOP (rituximab, adriamycin, cyclophosphamide, vincrstine, prednisone)
What are clinical pearls of Diffuse Large B-cell lympoma?
most aggressive NHL in adults and most common, quickly fatal if not treated, usually CD20+, so treat with rituxiab
t(14;18) is most common in which NHL? What's the result?
Follicular lymphoma, Bcl-2 translocated to avoid apoptosis
t(11;14) is most common in which NHL? What's the result?
Mantle cell lymphoma, increase in Cyclin D1
What is usually the cause of MALT lymphoma?
H. pylori infection