Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Lymphoma
Hematology
| Question | Answer |
|---|---|
| Hodgkin Disease includes (types): | Nodular Sclerosing (80%); LPHD; Classical Hodgkin Dz; Mixed cellularity |
| Non-Hodgkin Disease includes (types): | Follicular; Burkitt; Diffuse lg B-cell; Marginal zone; Cutaneous T-cell; Anaplastic large cell |
| Group of cancers w/enlarged lymphoid tissue, spleen, liver, & Reed-Sternberg cells | Hodgkin Dz |
| Hodgkin Disease prevalence | 7,900 cases/year. Bimodal: 20-40 then after 50; rare in kids <5; more common in men 15-45 |
| Virus found in 40–50% of Hodgkin disease cases | EBV |
| Hodgkin Dz mechanism of spread in pt | Usually arises in a single area and spreads to contiguous nodes (“next-door disease”) |
| Hodgkin Dz S/S | Painless cervical , supraclavicular, & mediastinal LAD (pain w/drinking alcohol); constitutional B symptoms; SOB common with mediastinal mass. |
| Hodgkin Dz findings | Nodular sclerosis (esp young pt); Mixed cellularity (esp in older pts); prob infxs etiology in young pts (mononuc, x3 risk); 5-10% = extranodal presentation (lung, liver, bone marrow); Chest Xray: often mediastinal mass |
| Hodgkin Dz diagnostics | CXR, CT chest, abdomen, pelvis; PET scan; LN & bilateral BM bx. HIV test. |
| Hodgkin Dz Stage I: | one lymph node region |
| Hodgkin Dz Stage II: | two lymph node areas on same side of the diaphragm |
| Hodgkin Dz Stage III: | nodal disease, both above and below the diaphragm. Also may be extralymphatic (IIIE) or involving spleen (IIIS) or both (IIISE) |
| Hodgkin Dz Stage IV: | Extranodal disease. A: no sxs. B: sxs. C: bulky disease (eg, mediastinal widening) |
| Hodgkin Dz mgmt: Stage I and IIa: | Radiation alone |
| Hodgkin Dz mgmt: Stage IIb: | Controversial, radiation +/- chemotherapy |
| Hodgkin Dz mgmt: Stage III: | Chemo +/-radiation (ABVD) |
| Hodgkin Dz mgmt: Stage IV: | Chemotherapy |
| Hodgkin Dz: Five year survival rate: | > 80% (Will usually recur in 2 years if at all) |
| Hodgkin Dz: if relapse: | Consider high dose chemo followed by BMT |
| Hodgkin Dz mgmt | Chemo: ABVD; give chemo Q2 weeks x 4-6 cycles. Re-scan after 2-3 cycles to determine response. IFRT follows chemo. Watch for toxicity/neutropenia (use CSFs) |
| 5th most common malignancy in US | NHL |
| NHL prevalence | 60,000 new cases annually; median age 50 yrs; incidence higher in pts w/immunodeficiencies, h/o EBV, exposures to pesticides/solvents |
| Disease arising from cells in lymphoid tissue (90% of cases are derived from B-lympocytes) | NHL |
| 3 Grades of NHL | Indolent (low grade, slow growing); Intermediate (aggressive, mix of small to large cells); High Grade (very aggressive) |
| NHL S/S | Persistent, painless, isolated or diffuse LAD (retroperitoneum, mesentery, pelvis, extranodal: skin, GI tract); B symptoms (intermediate and high-grade dz); abd pain, N/V, bleeding, edema |
| NHL findings | Normal CBC but poss anemia, thrombocytopenia, & leukopenia; occ lymphoma cells on diff; bulky lymphadenopathy (poss cause jaundice, hydronephrosis, SVC syndrome, bowel obstruction, wasting) |
| NHL staging | CT chest, abdomen, pelvis; PET scan??; Unilateral or bilateral BM bx; LDH (tumor marker); LP if CNS dz is suspected |
| tumor lysis prophylaxis | Allopurinol, 300 mg/day, hydration, diuretics. May be indicated in NHL |
| Role of surgery in NHL | Diagnostic |
| Mgmt of Low Grade NHL | Dynamic observation (watch & wait) average of 6 yrs after dx. Rituximab weekly x4 weeks or R-CHOP or CHOP |
| Mgmt of Intermediate Grade NHL | R-CHOP or R-ICE or Bexxar (radiolabeled I-131) or Zevalin (radioimmunotherapy). ?BMT or SCT in relapse |
| Mgmt of High Grade Lymphoma (large B-cell lymphoma) | R-CHOP or R-ICE. Many lymphomas treated w/specific therapies (Burkitt lymphoma, post transplant lymphoproliferative disorder) |
| Lymphoblastic lymphomas are treated with: | Regimens similar for T-cell ALL |
| Bulky lymphadenopathy seen in: | CLL; NHL |
| Pel-Ebstein fever pattern is seen in: | Hodgkin disease (alternating periods of febrile and afebrile for days-weeks) |
| Hodgkin disease complications | Spinal cord compression. Late-treatment cardio & pulmo dz. 2nd malignancy. Hypothyroid & infertility after radation. Lower immunity. |
| Ann Arbor system is used to classify stages of: | Hodgkin disease and NHL |
| Working Formulation and REAL classification system are used to classify diagnoses of: | NHL (low, intermediate, and high-grade) |
| Constitutional B symptoms | fever, drenching night sweats, wt loss |
| Rituximab (monoclonal Ab) targets: | B-cells SAg CD20 cells |
| R-CHOP = | rituximab plus cytoxan, adriamycin, vincristine, prednisone |
Created by:
Abarnard
Popular Medical sets