2.9 advantages in treatment of haem cancers Flashcards

1
Q

What imaging do we use to predict patients with HL will respond to standard chemo?

A

interm PET scanning

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2
Q

how does radiotherapy work?

A

DNA damage
initiates apoptosis

  • single treatment in early disease
  • combo with chemo in extensive disease
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3
Q

long term toxicity of radiotherapy

A

pulmonary fibrosis
cardiomyopathy
malignancy- breast, lung
premature atherosclerosis

need to fractionate dose and reduce field size

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4
Q

Treatment for DLCL (diffuse large b-cell lymphoma)

A

CHOP regimen

cyclophosphamide
doxorubicin
vincristine
prednisolone

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5
Q

late effects of chemotherapy

A
cardiomyopathy
infertility
premature gonadal failure 
secondary MDS 
leukaemia
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6
Q

Hodgekin’s lympthoma

A
A= absence of 
B= presence of more of: 
-fever >38 
-night sweats
-weight loss >10% body wt in 6 months
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7
Q

How do you cure early stage hodgkin’s disease

A

cured with chemotherapy- 6 cycles or
radiotherapy- mantle or inverted Y fields alone

or combined

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8
Q

how do you differentiate between metabolically active tissue and fibrosis

A

PET

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9
Q

if PET becomes negative after 2 of 6 planned ABVD (chemo and radio) there is a 90% chance of never relapsing

A

TRUE

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10
Q

enhances natural immunity

A

interferon alpha

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11
Q

this biological modifier alters the microenvironment of HL

A

thalidomide

lenalidomide

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12
Q

this enhances levsl of anti-proliferative molecules by blocking degradation (protesome inhibitor)

A

velcade

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13
Q

what cancers can you use interferon alpha for?

A
chronic phase CML 
hairy cell leukaemia 
renal carcinoma
melanoma 
some lymphomas
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14
Q

what are the side effects of interferon A?

A

flu life
depression
neurological

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15
Q

where does thalidomide work?

A

anti-VEGF, blocks IL6 anti-TNFa

anti-IFN-y

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16
Q

side effects of thalidomide

A

teratogenic
somnolence
neurological
thromboembolism

lenalidomide less toxic and greater efficacy

17
Q

how does velcade-bortezomib work?

A

blocks ubiquitination of proteins before destruction by proteosome

results in accumulation of I-kb, so reduced NK-kb

18
Q

molecular targetting

A

imatinib

19
Q

monoclonal antibody therapy

A

rituximab

20
Q

negative prognostic indicators of high grade NHL

A

older >60
bulky disease
poor WHO performance status

21
Q

which b-cell malignacies have the highest expression of CD20?

A

hairy cell
large cell
burkitts lymphoma
marginal zone

22
Q

how does MabThera work?

A

helps killer leukocytes and complement bind the CD20 on malignant B-cells

23
Q

are monoclonal antibodies curative in low grade NHL?

A

No, but promising.

24
Q

what is the new gold standard for high grade NHL treatment?

A

rituximab plus CHOP

25
Q

anti-CD30 is used in what cancer?

A

hodgkins

conjugated to chemotherapy for targetted chemotherapy

26
Q

relapsed hodgekin’s disease

A

rentuximab vedotin

27
Q

anti-her2 (herceptin)

A

breast cancer