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Exam 2
Lecture 8- Chronic Leukemias
50
Art History
7th Grade
02/11/2014

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Term
Char of CML
present at what age?
male or female
Definition
any age (median 67)
male
Term
phase of CML with <10% blasts
which is <15%
which is >20
Definition
Term
etiology of CML-3
any of them heriditary?
Definition
radiation
benzene
atomic bomb
no heriditary
Term
Pathophys of CML is where what dominates hematopeosis
Definition
single malignant trnasformation
Term
in CML there is aquisitoin of what mutation?
this generates what?
Definition
philadelphia (9,22)
BCR-Abl tyrosine kinase
Term
what makes up 95% of diagnosis for CML
Definition
BCR abl gene +
Term
what is the big symtpo of CML?
what cna it lead to-2
Definition
splenomegaly
abd pain, anorexia
Term
lab findings of CML-5
Definition
decreased Hgb
platelt cnt increased
WBC 25,000- 100,000
increased LDH/uric acid
increasefd Vit B12
Term
tx fo CML, the goal is it?
Definition
eradicate Phil chrom
Term
the only cure for CML is?
Definition
bone marrow trnasplant (so the drugs just prolong survival)
Term
drug therapies to help with CML-3
Definition
tyrosine kinase inhibitrs (1st line)
hydroxyurea
interferon+cyterabine
Term
def:
normalization of WBC, Plts, and no spenolmegaly
Definition
heme repsonse
Term
def:
has to do with Ph + findigns in FISH
Definition
cytogeneitc response
Term
def:
deals with mRNA findings of BCR Abl thru PCR analys
Definition
molecular resps
Term
* those with a complete+major resposne did better for survival
Definition
Term
drug of choice for CML
Definition
gleevac/ imintinib
Term
dosing for gleevac for chronic CML
accelerated and blast?
Definition
400 mg PO
600 mg PO
Term
ADEs of imanitib-4
Definition
hepatox
meylosupp
edema
arthalgia
Term
Heme respon btwn interferon + cytarabine vs gleevac
Definition
about the smae
Term
complete cytoegnic rspn for gleevac vs interferon +cytarabine
Definition
way more for gleevac!dastinib
nilotinib
Term
2 other drugs like imatinib that cna now be sued for CML
Definition
Term
what drug is 3A4 subt
Definition
dasitinib
Term
ADE of dasitinib
Definition
thombocytoipenia
Term
ADE of nilotinib-2
Definition
increased LFTs
prlong QTC
Term
allogenic BMT can be used for CML if done with how long after diagnosis?
Definition
1 yr
Term
is allogenic BMT affect by prior alpha interferon tx?
Definition
no
Term
why is mortality rate from allogenic BMT high?-2
Definition
infeciton
GVHD
Term
frist line treatment for CML TKI resitant
-chronic
-if accelerated/blast what else could be 1st line?
Definition
TKI increase dose
allogenic trnasponatinib
Term
what med works agaisnt the T3151 mutation of CML?
Definition
Term
what meds marketing is suspending due to life threatneing blood clots?
what ar the FDA reccomednaitons-3
Definition
ponatiinib
dont start new pts, d/c if not working, eval in pts its working for
Term
whihc has more % of cancer, CLL or CML
Definition
CLL
Term
predispoing factors o CLL-2
what is viral/radiot risk level
Definition
genetics (relativesa at incred risk)
unknwon etiology
no evidence
Term
presentaiton of CLL-3
Definition
lymphadenopahty of neck/shoulder
spenlomegaly
wt loss
Term
lab findings of CLL-3
Definition
increased WBC
thombocytopenia
lymph >10,000
Term
Staging of CLL
stage 0
Definition
lymph>5,000
Term
stage of CLL
stage 1
Definition
lemphoadophaty
Term
stage of CLL
stage 2
Definition
spenlogmegaly
Term
stage of CLL
stage 3
Definition
hgb <11
Term
staging cLL
stage 4
Definition
Plts <100
Term
factros that mke CLL poor prognosis-5
Definition
short lymp doubling
CD38
ZAP 70
higher stage at dx
cytogenic abnormalites
Term
the most important cytogenic abnormaliy that causes shortest survivial for CLL is-
Definition
1p deletion
Term
what ppl dont you tx for CLL
Definition
asymptomatic 0-2 staging
Term
Tx for CLL, esp for elderly?
Definition
chlorambucil
Term
tx for CLL that can have myleosuppression
Definition
bendamustine
Term
which tx for CLL do you need bactrim prophylaxis for?
Definition
fludarabine
Term
first linet tx for young and high risk CLL
Definition
FCR
Term
first line tx for elderly and high risk CLL
Definition
try fludarabine, if not then use single agent
Term
firs tline tx fr elderly and low risk CLL
Definition
singe agent
Term
what drug do you pre tx with tyelnol, antihist, and steroid?
Definition
obintuzumab
Term
which trnasplant has mroe repsonse in CLL?
Definition
autoglous
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