Week 4: Case studies of leukemia/lymphoma Flashcards Preview

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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?

Fertility counseling


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


Can immune suppression lead to lymphoproliferative disorders? How do you treat it?

Yes it can lead to B cell proliferation because of T cell suppression, back off immune suppression