Term
| Does not contain Reed-Sternberg cells |
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Definition
| Diffuse Large Cell Lymphoma & Follicular Lymphoma |
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Term
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Definition
-H & P
-CBC with differential, CMP, LDH, ESR
-CT scan, Ab, Pelcis PET-CT
-BM biopsy
... |
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Term
| What is the malignant cell in Hodgkins Lymphoma? |
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Definition
Reed- Sternberg Cell (B Cell)
-eosinophils, t cell, MP and NK cells are all reactive cells |
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Term
| Associated with Hodgkin's Lymphoma |
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Definition
-EBV
-Family history
-High standard of living
-Immunosuppression
-Young age
-Old age |
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Term
| Staging of HL (I, II, III, IV) |
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Definition
I: 1 LN area either above or below diaphragm
II: 2 LN on same side of diaphragm
III: LN on both sides of diaphragm
IV: involvement of extra-lymphatic tissue (BM, Liver, Lung)
"Ann Arbor Staging System" |
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Term
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Definition
Fever (100.4 or greater at least 1/day)
Night Sweats (drenching)
Weight Loss ( > 10% of baseline weight) |
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Term
|
Definition
NHL:
-B cell: aggressive, intermediate, indolent
-T cell: peripheral T Cell lymphoma, cutaneous T Cell Lymphoma
HL:
-Nodular sclerosis
-Lymphocyte depleted
-Lymphocyte predominant
-mixed cellularity |
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Term
| HL cells spread in a relatively orderly fashion to contiguous sites |
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Definition
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Term
|
Definition
| Adriamycin, Bleomycin, Vinblastine, and Dactinomycin |
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Term
|
Definition
minimal BM toxicity, dose-related pneumonitis & pulmonary fibrosis
*monitor pulmonary toxicities (ie: SOB, cough, rales) |
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Term
| Vinca Alkaloids: Vinblastine & Vincristine |
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Definition
MOA: spindle poison: binds tubulin and prevents polymerization of tubulin to form microtubules (disrupts mitotic spindles & decreases mitosis)
Clinical Use:
Vinblastine: HL (ABVD)
Vincristine: acute lymphocytic leukemia (ALL), HL (MOPP)
SE:
Vinblastine: BM depression
Vincristine:
-neurotoxicity (peripheral neuropathy, peresthesis)
-Low incidence of BM depression |
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Term
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Definition
SE: myelosuppression-mild, NV
USES: HL (ABVD)
MOA: alkylating agent |
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Term
| What causes Acute Lymphocytic Leukemia (ALL)? |
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Definition
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Term
| What is most important in the evaluation of suspected ALL? |
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Definition
| Peripheral blood for flow cytometry (fastest & necessary) , BM biopsy and aspirate, BM cytogenetics, BM flow cytometry, BM FISH for common genetic abnormalities |
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Term
|
Definition
A. Morphology
L1: uniformity of cell morphology
L2: cariation in size and shape
L3: characteristic cytoplasmic granules (white inclusion bodies)
B. Immunophenotype |
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Term
| Bad prognostic factors for ALL |
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Definition
-Male
-afroamerican
-WBC > 30,000 Dx
-CNS involvement at Dx
-Mature B cell phenotype
- Ph + (9,22)
-Hypodipoidey
children: 60-80 cure rate
Adults 30-50 cure rate |
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Term
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Definition
-induction chemotherapy: followed by intensification chemotherapy occasionally with BM transplant from matched sibling or matched unrelated donor
-Drugs 'hyperCVAD' cyclophosphamide, vincristine, daunorubicin, dexamethasone, cytrarabine, methotrexate, intrathecal therapy |
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Term
| cytophosphamide (drug for ALL) |
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Definition
MOA: alkylating agent, binds DNA and decreases replication
-a prodrug, req activation by hepatic cytochrome P-450
-used orally for ALL (hyperCVAD), HL (CHOP) and ovarian and breast cancer (CMF)
SE: myelosuppression, NV, Hemorrhagic cystitis (Mesna, a thiol drug, is given as uroprotectant to bind to the reactive intermediate and decrease it's toxicity) + VIGOROUS hydration |
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Term
| Adrenocorticosteroids (ie: dexamethasone) for ALL |
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Definition
MOA: immunosuppressive, interfere w/ lymphocytic proliferation by inhibiting mitosis and have a lympholytic effect that causes regression of lymphatic tissue
Used: acute and chronic LL
SE: cushings habitus |
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Term
| Pyrimidine antagonists (cytarabine) |
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Definition
MOA: inhibits DNA Pol
Used: IV, AML and HL
SE: myelosuppression |
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Term
| Folic Acid antagonists (methotrexate) (Tx ALL) |
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Definition
MOA: competitively inhibits DHF Reductase (thus cannot get tetrahydrofolate for DNA synth), inhibition reversed by folinic acid
Uses: ALL: intrathecally to decrease relapse of CNS leukemia
DOC for Tx of choriocarcinoma
SE: dose-related myelosuppression, hepatic cirrhosis & fibrosis, and Teratogenesis!!! |
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Term
| Least likely DDx for CLL case 3? |
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Definition
-Follicular Cell Lymphoma b/c doesn't circulate and has no lymphadenopathy
CLL, MCL, HCL, MZL all circulate. |
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Term
| What is the most important test in the initial veal of suspected CLL? |
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Definition
-peripheral blood for flow cytometry MOST IMP
but also imp...
-BM biopsy, aspirate, cytogenetics etc... |
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Term
|
Definition
Stage 0- low risk: lymphocytosis
Stage I- intermediate: lymphocytosis, LAN
Stage II - high: Lymphocytosis + organomegally
Stage III- high Lymphocytosis+ anemia
Stage IV- high Lymphocytosis+ thrombocytopenia
Stage A- < 3 LN bearing sites
Stage B- > 3 LN bearing sites
Stage C- anemia or thrombocytopenia
Case 3: Stage 0 or Stage A |
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Term
T/F
Proliferation centers are pathognomonic for CLL/SLL? |
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Definition
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Term
| Prognostic Criteria for CLL |
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Definition
| Significant: genetic abnormalities, VH gene mut, CD38, ZAP-70, Beta-2 microglobulin, lymphocyte doubling time |
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Term
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Definition
-FCR: fludarabine, cytoxan, rituxan
-Rituxan-Bendamusine
-Rituxan single agent
-Campath
-CHOP chemo
-Allogeneic BM transplant |
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Term
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Definition
MOA: purine analog and interferes with DNA synth and repair by --I DNA pol
Used: CLL
SE: dose-lmting myelosuppression |
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Term
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Definition
MOA: monoclonal Ab targeted against CD20 Ag on B cells
SE: infusion reactions (ie: hypotension...) |
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Term
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Definition
MOA: recomb humanized monoclonal Ab that is directed against CD52--deplete cells by Ab-dependent lysis
Uses: CLL in patients with refractory to FCR regimen--IV
SE:monitor for opportunistic infxn |
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Term
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Definition
Cyclophasphamide
Doxorubicin (Hydroxydaunorubicin)
Vinicristine (Oncovin)
Prednisone |
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Term
| Issues with Management for CLL |
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Definition
Infxn: pneumonia, cellulitis
Autoimmune complications: hemolytic anemia, immune thrombocytopenia (ITP), can be refractory tx |
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Term
| Score for Follicular lymphoma: |
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Definition
FLIPI Score
(follicular lymphoma international prognostic index)
slide 146... know?? |
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Term
|
Definition
| mature terminally diff plasma cells which secretes Ig as its job. |
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Term
| What test should you do for MM? |
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Definition
| Serum prtn electrophoresis (mjr prtn should be albumin) if we see a monoclonal Ab spike.... |
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Term
| MGUS & solitary plasmacytoma |
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Definition
MGUS:
-present in 2% of 50 y/o
- no clinical criteria to meet dx of plamacytoma or myeloma
-1% risk/year of progression to a clonal disorder
Solitary Plasmacytoma:
-no clinical criteria of myeloma
- radiation is curative
-25% chance of getting myeloma (think!?!) |
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Term
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Definition
I: hgb > 10, serum Ca normal, xray normal or solitary bone plasmacytoma only
II: neither stage I or III
III:
A: normal renal fxn cr < 2.0 mg/dl
B: abnormal renal fxn due to creatinine level
FINISHN 166 |
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Term
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Definition
markers: increase in B2
FINISH 167 |
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Term
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Definition
MP regime: Melphalan (alkylating agent) Prednisone
VAD regime: Vincristine, Doxorubicin (Adriamycin), Dexamethasone
NEW:
Thalidomide |
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Term
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Definition
Chemistry: teratogenic effects (during peg: phocomelia)
MOA: --I angiogenesis and is anti inflammatory and immunomodulatory, --I TNF alpha decreasing phagocytosis b neutrophils and increased CMI
USes: MM and Erythema nodosum leprosum
SE:
Teratogenic (closely regulated) |
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Term
|
Definition
MOA: reversible proteosome --I
Uses: MM
SE: N, V, asthenia, peripheral neuropathy |
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