Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Thera IX > 19 Lymphoma Kasravi > Flashcards

19 Lymphoma Kasravi Flashcards

1
Q

What are the signs and symptoms of Non-Hodgkin’s Lymphoma (NHL)?

A

“B” Symptoms (20%) - Fever, Weight loss, Drenching night sweats. Lymphadenopathy (65%) - Peripheral (most commonly cervical), 20% mediastinal. Fatigue, pruritus, malaise. Bone marrow involvement (33%). Extranodal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is use in the Ann Arbor Staging of Non-Hodgkin’s Lymphoma (NHL)?

A

“B” symptoms. Bulky disease (tumor mass > 10cm in greatest diameter, localized (stage I or II) w/ bulky disease are treated as advanced disease (stage III or IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are used to categorize patients in the different risk categories for Non-Hodgkin’s Lymphoma (NHL)?

A

Age > 60. Stage III or IV. >2 extranodal sites. Performance status > 2. LDH > norma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the characteristics of Low grade NHL?

A

Cure if rare. Median overall survival (5-8 years). Prognosis depends on (age, bulk of disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the different treatment options for Low Grade NHL?

A

Observation. Radiation for localized. Chemotherapy for disseminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the ADRs with Prednisone?

A

Insomnia (take dose QAM). Hyperglycemia. Increase appetite. Indigestion, gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What dosage forms does Prednisone come in?

A

Oral solution: 1mg/mL. Concentrate oral solution (5mg/mL). Tablet: 1, 2.5, 5, 10, 20, 50mg. Take with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the ADRs with Cyclophosphamide (Cytoxan)?

A

Hemorrhaghic cystitis (at high dose) - MESNA, hydration. Alopecia, Myelosuppression (leukopenia), infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the Emetogenicity like for Cyclophosphamide (Cytoxan)?

A

High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the dose adjustment like for Cyclophosphamide (Cytoxan)?

A

Hepatic: no official recommendation. Renal < 10: 75% dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What dosage form does Cyclophosphamide (Cytoxan) come in?

A

Injectable, oral tablet 25, 50mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Fludarabine (Fludara) indicated for?

A

CLL (NHL not FDA approved, but commonly used)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the ADRs with Fludarabine (Fludara)?

A

Myelosuppression (leukopenia, thrombocytopenia). Increased risk for opportunistic infection d/t decreased CD4 counts, pneumonia. Fever, fatigue, edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Emetogenicity like for Fludarabine (Fludara)?

A

Very low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is dose adjustment like for Fludarabine (Fludara)?

A

CrCl 30-70: 20% dose reduction. CrCl < 30: not recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is Fludarabine (Fludara) administered?

A

Infusion over 30-60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the ADRs with Mitoxantrone (Novantrone)?

A

Discoloration of urine, saliva, tears, and sweat (blue-green for 24 hrs post). Cardiotoxicity (CHF, decreased cardiac function (LVEF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Emetogenicity like for Mitoxantrone (Novantrone)?

A

Moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the dose adjustment like for Mitoxantrone (Novantrone)?

A

Hepatic (no official recommendations). T.bili 1.5-3.0: 50% dose reduction. T.bili > 3.0: 75% dose reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a caution with Mitoxantrone (Novantrone) use?

A

Vesicant (management): DMSO, cold. Classified as an irritant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Chlorambucil (Leukeran) used for?

A

CLL, HD, NHL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the ADRs with Chlorambucil (Leukeran)?

A

Rash, myelosuppression (DLT). Transient increase in LFTs, hyperuricemia. Less common: hepatotoxicity, seizure, drug fever, pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the Emetogenicity of Chlorambucil (Leukeran)?

A

Very low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How should Chlorambucil (Leukeran) be taken?

A

On empty stomach. BA decreased by 10-20% when taken with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the treatment options for Aggressive NHL?
Localized: chemo +/- radiation. Disseminated: combination chemotherapy. R-CHOP: 1st line
26
What does R-CHOP stand for?
R: Rituximab (Rituxan). C: Cyclophosphamide (Cytoxan). H: Hydroxyl Daunorubicin. O: Vincristine (Oncovin). P: Prednisone
27
How is Rituximan (Rituxan) dosed in R-CHOP?
375mg/m2 IVPB day 1
28
How is Cyclophosphamide (Cytoxan) dosed in R-CHOP?
750mg/m2 IVPB day 3 (or day 1)
29
How is Hydroxyl Daunorubicin dosed in R-CHOP?
50mg/m2 IVP day 3 (or day 1)
30
How is Vincristine (Oncovin) dosed in R-CHOP?
1.4mg/m2 (max 2mg) day 3 (or day 1)
31
How is Prednisonse dosed in R-CHOP?
100mg/day PO days 3-7 (or days 1-5)
32
How often is R-CHOP repeated?
Repeat cycle every 21 days
33
What is the MOA of Rituximab (Rituxan)?
Monoclonal antibody. Anti-CD20. Chimeric (mouse/human)
34
What is Rituximab (Rituxan) used for?
NHL, RA, CLL
35
What are the infusion related reactions with Rituximab (Rituxan)?
Fever, chills/rigors, angioedema, flushing, HTN. Can premedicate with APAP
36
What is a BBW for Rituximab (Rituxan)?
Tumor Lysis Syndrome (high tumor burden (usually with 1st dose)). Fatal infusion reaction
37
How is Rituximab (Rituxan) prepared?
In D5W or NS, final concentartino 1-4mg/mL
38
What are the ADRs with Doxorubicin (Adriamycin)?
Myelosuppressive (Leukopenia). Urine/saliva/tear discoloration - red/orange. Cardiotoxicity
39
What is the Emetogenicity like with Doxorubicin (Adriamycin)?
Dose dependent. 20-60mg: moderate
40
What does Doxorubicin (Adriamycin) need to be dose adjusted?
AST/ALT 2-3x ULN: 75% of dose. >3x or T.bili 1.2-3: 50% of dose. T.bili 3.1-5: 25% of dose
41
What caution should be taken with Doxorubicin (Adriamycin)?
Vesicant (management): DMSO or Totect, cold
42
What are the ADRs with Vincristine (Oncovin)?
Peripheral neuropathy (DLT). Constipation (DLT)
43
What is Vesicant management like for Vincristine (Oncovin)?
Hyaluronidase (Amphadase, Wydase, Vitrase). Warm preferred over cold
44
When does Vincristine (Oncovin) required dose adjustment?
Hepatic
45
What is a warning with Vincristine (Oncovin)?
DO NOT remove covering until the moment of injection. For intravenous use only. FATAL if given intrathecally
46
What are the ADRs with Etoposide (Toposar, VePesid) - salvage therapy?
Hypotension if infused too rapidly. Myelosuppression (leukopenia > thrombocytopenia). Alopecia, asthenia, fever
47
What is the Emetogenicity with Etoposide (Toposar, VePesid)?
Mild
48
What does stability of Etoposide (Toposar, VePesid) depend on?
Concentration dependent
49
When does Etoposide (Toposar, VePesid) need dose adjustment?
Renal, Hepatic
50
What do you need to do when administering Etoposide (Toposar, VePesid)?
Use in-line filter with high doses d/t high likelihood of precipitation
51
What are the ADRs with Cytarabine (Cytosar, ARA-C) - salvage therepy?
Ocurlar (use opthalmic corticosteroids - Prednisolong (Pred-Forte)). Fever, rash, hyperuricemia. Myelosuppression. Acute increase LFT, mild jaundice. Neurotoxicity - high dose
52
What is the Emetogenicity of Cytarabine (Cytosar, ARA-C)?
High
53
What are the ADRs with Cisplatin (CDDP, Platinol)?
Neurotoxicity: Peripheral neurotoxicity is dose- and duration-dependent. Myelosuppression. Nephrotoxicity, ototoxicity
54
What is the Emetogenicity like for Cisplatin (CDDP, Platinol)?
High
55
What is the stability of Cisplatin (CDDP, Platinol) like?
Stable in saline only
56
When does Cisplatin (CDDP, Platinol) need dose adjustment?
Renal only
57
What is done for Cisplatin (CDDP, Platinol) as a vesicant?
In high dose. Sodium thiosulfate and cold
58
What needs to be monitored while on Cisplatin (CDDP, Platinol)?
Renal function, electrolytes, CBC, hearing test, neuro exam
59
What are the ADRs with Ifosfamide (IFEX) - salvage therapy?
Alopecia. Confusion, hallucination (avoid with BZD). Myelosuppression. Metabolic acidosis. Hemorrhagic cystitis, hematuria (ALWAYS give Mesna)
60
What is the Emetogenicity of Ifosfamide (IFEX)?
Moderate
61
What does Ifosfamide (IFEX) need dose adjustment?
Renal if significant impairment. Hepatic: 75% dose reduction if AST > 300 or T.bili < 3
62
What is the MOA of Mesna (Mesnex)?
Mesna oxidized to dimesna in blood. Reduced in the kidney back to mesna yielding a free thiol group. Binds to and inactivates acrolein
63
What are the ADRs with Carboplatin (Paraplatin)?
Myelosuppression (dose related and dose limiting)
64
What is the Emetogenicity of Carboplatin (Paraplatin)?
Moderate
65
What are the DDIs with Carboplatin (Paraplatin)?
Nephrotoxic drugs. AGs increase risk of ototoxicity
66
What are the ADRs with Bendamustine (Treanda)?
Myelosuppression (DLT), rash, HA, increased bilirubin, peripheral edema, TLS
67
What is the stability of Bendamustine (Treanda) like?
Concentration dependent. Stable in NS
68
What should be administered before Bendamustine (Treanda) use?
Premedicate to prevent hypersensitivity (APAP, antihistamine +/- corticosteroid)
69
What is the pathogenesis of Hodgkin's Disease (HD)?
Bimodal age distribution (15-45 and > 50. More common in caucasian). Presence of Reed-Sternberg (large size, binucleated, cellular origin characteristic of macrophage and lymphocyte)
70
What is Stage I HD?
Involvement of single lymph node region or single extralymphatic site
71
What is Stage II HD?
Involvement of two or more lymph node regions on same side of diaphragm; may include localized extralymphatic involvement on same side of diaphragm
72
What is Stage III HD?
Involvement of lymph node regions on both sides of diaphragm; may include spleen or localized extranodal disease
73
What is Stage IV HD?
Diffuse extra-lymphatic disease (e.g. in liver, bone marrow, lung, skin)
74
What is the treatment strategy for Stage IA or IIA HD (with favorable prognostic factors)?
Radiation. Radiation +/- chemotherapy
75
What is the treatment strategy for Stage IB or IIB HD (with bulky disease)?
Chemotherapy + Radiation. Combination chemotherapy
76
What is the treatment strategy for Stage III or IV HD?
Chemotherapy +/- radiation
77
What is the treatment strategy for HD relapse?
SCT (stem cell transplant). Salvage therapy
78
What is the gold standard treatment option for HD?
ABVD (used to be MOPP)
79
What does MOPP stand for?
M: Mechlorethamine (Mustargen). O: Vincristine (Oncovin). P: Procarbazine (Matulane). P: Prednisone
80
What does ABVD stand for?
A: Doxorubicin (Adriamycin). B: Bleomycin (Blenoxane). V: Vinblastine (Velban). D: Dacarbazine (DTIC). Days 1 and 15 every 28 days for 6-8 cycles
81
What needs to be done before Bleomycin (Blenoxane) administration?
Test dose. Monitor vital signs, wait 1 hr prior to giving dose
82
What are the ADRs to look out for with Bleomycin (Blenoxane)?
Pulmonary fibrosis (cough, dypsnea, increased toxicity with O2 treatment up to 1 year after). Monitor PFT. Acute frebrile reaction. Dermatological SE
83
What is the emetogenicity like for Bleomycin (Blenoxane)?
Very low
84
When does Bleomycin (Blenoxane) need to be dose adjusted?
Renal
85
What is the maximum cumulative lifetime dose of Bleomycin (Blenoxane)?
400 units
86
What are the ADRs with Vinblastine (Velban)?
Myelosuppressive (Leukopenia)
87
What is the Vesicant management for Vinblastine (Velban)?
Hyaluronidase (Amphadase, Wydase, Vitrase). Warm/cold
88
When does Vinblastine (Velban) need dose adjustment?
Hepatic
89
What is a warning with Vinblastine (Velban)?
DO NOT remove covering until the moment of injection. For intravenous use only. FATAL if given intrathecally
90
What are the ADRs with Dacarbazine (DTIC)?
Myelosuppressive. Irritant (possible vesicant). Infusion related reaction (painful, dexamethasone as premedication, hot pack)
91
What is the Emetogenicity of Dacarbazine (DTIC)?
High
92
How does MOPP compare to ABVD?
MOPP involved with more: Hematological toxicity, Infection risk, Neuropathy, Secondary leukemia, Infertility
93
What is the MOA of Brentuximab Vetodin (Adcetris)?
Antibody drug conjugate (Anti-CD30) with 3 components: 1) CD30-specific chimeric IgG1 antibody - cAC10. 2) Microtubule-disrupting agent - MMAE. 3) Protease cleavable dipeptide linker
94
What are the common ADRs with Brentuximab Vetodin (Adcetris)?
Rash, BMS, fatigue, peripheral neuropathy
95
What are the serious ADRs with Brentuximab Vetodin (Adcetris)?
Anaphylaxis, PML, pulmonary toxicity, SJS
96
What are the potentially fatal late complications of HD treatment?
Acute myelomonocytic leukemia. Diffuse, high-grade NHL. Solid tumors (mostly lung and breast cancer). Bacterial sepsis post splenectomy or spleen irradiation
97
What are the serious late complications of HD treatment?
Myocardial damage secondary to radiation/anthracyclines. Lung fibrosis d/t radiation plus bleomycin. Sterility in men and women. Growth abnormalities in children and adolescents. Opportunistic infections

Thera IX (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions