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Oncology Exam 2 > AML/ALL KEY FACTS > Flashcards

AML/ALL KEY FACTS Flashcards

1
Q

Intermediate risk of relapse in AML

A

normal cytogenetics

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2
Q

Poor risk of relapse in AML

A
  • >60 yo
  • WBC > 100,000
  • CNS involvement
  • > 5 genetic abnormalities
  • FLT3 mutation
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3
Q

< 60 years old AML induction treatment

A

7+3

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4
Q

< 60 years old AML residual disease treatment

A

5 + 3

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5
Q

< 60 years old AML FLT3 mutation

A

midostaurin

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6
Q

< 60 years old AML CD 33

A

gemtuzumab

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7
Q

< 60 years old AML difficult to treat patient, poor outcomes, previous exp to chemo

A

Vyxeos

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8
Q

7+3 regimen

A
  • 7 days continuous cytarabine 100 mg/m2 IV
  • 3 days anthracycline:

Daunorubicin

Idarubicin

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9
Q

Daunorubicin for AML

A

Higher CR with 90 mg < 60 years old

90 mg ONLY in < 60 years old

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10
Q

Main toxicity of gemtuzumab

A

Hepatotoxicity

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11
Q

Who do you use Vyxeos in?

A

AML patients

  • difficult to treat
  • poor outcomes
  • previous exposure to chemo
  • older patients
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12
Q

T/F if a patient is started on 7+3 they can switch to Vyxeos if it is not working?

A

FALSE

NOT interchangeable

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13
Q

T/F you can use Vyxeos in older AML patients

A

True

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14
Q

Main toxicity ofr venetoclax

A

Monitor for TLS

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15
Q

Which AML drug do you decrease the dose of when using anti-fungal therapies?

What substrate is it?

A

Venetoclax

C34 substrate

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16
Q

> 60 years old AML treatment if unfavorable cytogenetics

A

Venetoclax daily + decitabine/azacitidine

or decitabine/azacitidine alone

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17
Q

Consolidation treatment for AML

A
  • Cytarabine 3000 mg/m2 IV BID on days 1, 3, 5: <60 yo
  • Cytarabine 1000 - 1500 mg/m2
  • Vyxeos
  • Decitabine/azacitidine + venetoclax
18
Q

Cytrabine dose in AML differences

A

< 60 years induction: 100 mg/m2

< 60 years consolidaiton: 3000 mg/m2

>60 years consolidation: 1000 - 1500 mg/m2

renal dysfunction: decrease dose

19
Q

Low dose cytrabine adverse reactions

A
  • pancytopenia (neutorpenia, anemia thrombocytopenia)
  • N/V/D
  • Cardiotoxicity
  • mucositis
20
Q

High dose cytrabine adverse reactions

A
  • Pancytopenia
  • N/V/D

- Hand-foot syndrome: reversible

  • Conjunctivitis: reversible
  • Neurotoxicity (cerebellar): irreversible
21
Q

What drugs can you use for APL?

A

Tretinoin (ATRA)

Arsenic (ATO)

22
Q

What is APL diagnosed by?

A

t(15;17)

23
Q

T/F ATRA causes QTc prolongation

A

False!

Arsenic (ATO) causes

24
Q

T/F Arsenic is pregnancy category X

A

False!

ATRA is category X

25
Q

Tretinoin and arsenic ADEs

A

Both: APL differentiation syndrome

ATRA: category X, not myelosuppressive

ATO: QT prolongation

26
Q

T/F never give vincristine intrathecally

A

true

27
Q

What is the backbone treatment for adult ALL?

A
  • vincristine
  • antracycline
  • corticosteroids

+/- cyclophosphamide, asparginase

28
Q

T/F AML is associated with t(9;22)

A

False

ALL

29
Q

What do you add if an adult with ALL has philadelphia +?

A

add TKI

  • imatinib
  • desatinib
  • nilotinib
30
Q

Which drug is very difficult to compound and what is it used for?

A

Blinatumomab

for ALL

31
Q

Major adverse reactions of blinatumab

A
  • Cytokine relase syndrome
  • Neurologic toxicity
  • TLS
32
Q

Who uses risk adapated therapy?

A

Pediatric ALL

33
Q

Who is very high risk in pediatric ALL risk adapted therapy?

A

Ph+

34
Q

Asparginase toxicities

A
  • pancreatitis
  • coagulation disorders
  • anaphylactic reactions
  • hyperglycemia
35
Q

T/F pediatric protocols for ALL use higher doses of myelotoxic agents

A

False

  • non-myelotoxic agents

Vincristine, steroids, asparginase

36
Q

T/F pediatric protocols for ALL use higher doses of MTX

A

True

37
Q

T/F pediatric protocols for ALL has more intermittent exposure to chemo

A

False!

continuous

38
Q

T/F adult protocols for ALL generally have prolonged neutropenia

A

True!

less continuous exposure to chemo

39
Q

T/F adult protocols for ALL use higher doses of antracyclines and cytrabine

A

true

40
Q

_____ protocols of ALL have a delay in HSCT and _____ protocols of ALL have early HSCT

A

pediatric

adult

Oncology Exam 2 (5 decks)

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