Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hodgkin's Lymphoma > Background and recommendations > Flashcards

Background and recommendations Flashcards

1
Q

What is considered an lymphatic organ?

A
  1. Thymus
  2. Spleen
  3. Waldeyer’s ring
  4. Appendix
  5. Peyer’s patches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of bulky disease per the mediastinal mass ratio (MMR)?

A

Mass more than 1/3rd widening of the greatest thoracic width on CXR

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

For the IP scores 0, 1, 2 what are the associated 5 year PF survivals?

A

0 - 84%
1 - 77%
2- 67%

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

What are the NCCN designated negative factors for Stage I to II patients?

A
  1. B symptoms present or ESR > 50
  2. MMR > 1/3 or any mass more than 10 cm
  3. More than 3 nodal sites
  4. 2 or more extralymphatic sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are NCIC designated negative factors for Stage I to II?

A
  1. Age 40 or more
  2. MC or LD
  3. B symptoms present or ESR > 50
  4. MMR > 1/3rd or any mass > 10 cm
  5. More than 3 extranodal sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

For what stages are the IP score useful?

A

Stage III and IV

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

What are the constituents of the IP score?

A
  1. Male
  2. Age > 45
  3. Stage IV
  4. Hemoglobin < 10.5
  5. < 4 g/dl
  6. Lymphocytes < 600/ml or 15K
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For the IP scores 3, 4, 5+ what are the associated 5 year PF survivals?

A

3 - 60%
4 - 51%
5+ 42%

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

What are GHSG designated negative factors for Stage I to II?

A
  1. ESR > 50 if A or ESR > 30 if B
  2. MMR > .33
  3. Any extralymphatic site
  4. More than 2 nodal sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Deauville 1-3 PET/CT response criteria

A

Uptake at the primary site is less than or equal to that of the liver

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

Deauville 4 PET/CT response criteria

A

Uptake at the primary site is moderately increased compared to the liver

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

Deauville 5a PET/CT response criteria

A

Uptake at the primary site is markedly increased compared to the liver

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

Deaville 5b PET/CT response criteria

A

New sites of disease are evident

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

Stanford V regimen

A
  1. Doxorubicin
  2. Vinblastine
  3. Mechlorethamine
  4. Etoposide
  5. Vincristine
  6. Bleomycin
  7. Prednisone

Add VEP and switched out dacarbazine

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

What is ABVD?

A
  1. Doxorubicin
  2. Bleomycin
  3. Vinblastine
  4. Dacarbazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is escalated BEACOPP?

A
  1. Bleomycin
  2. Doxorubibin
  3. Procarbazine
  4. Vincristine
  5. Etoposide
  6. Prednisone
  7. Cytoxan

Got rid of V, switched out dacarbazine, added VEPC

17
Q

What are the GHSG unfavorable risk factors?

A

ESR > 50 if A, or > 30 if B
MMR > 0.33
Nodal sites > 2
E lesion any

18
Q

What are the EORTC unfavorable risk factors?

A

Age 50 or older
ESR > 50 if A, > 30 if B
MTR > 0.35
>3 nodal sites

19
Q

What stages are the Unfavorable risk factors helpful for?

A

Stage I to II

20
Q

Treatment recommendation for patient with Stage IA to IIA Nodular lymphocyte predominant HL?

A
  1. Observe if complete resection has been performed

2. ISRT to 30.6 Gy at 1.8 Gy/fx

21
Q

Treatment recommendation for patient with Stage IB to IIB or bulky Nodular lymphocyte predominant HL?

A
  1. Chemotherapy + ISRT
22
Q

What labs are needed at work up?

A 
CBC with diff
ESR
LDH
LFT
BMP
Pregnancy test for women of childnearing age
23
Q

What imaging is needed for work up?

A

PET/CT scan
Diagnostic CT of the neck, chest, abdomen and pelvis
CXR

24
Q

What tissue diagnosis is needed?

A

Excisional biopsy

BM bx for B symptoms or Stage III-IV

25
Q

What special studies are needed up diagnosis?

A

MUGA scan
PFTs
HIV test

26
Q

What is the recommended treatment for Stage IA-IIA, favorable?

A
  1. ABVD for 2 cycles
  2. PET/CT

3a. If Deauville 1-3 or partial response on CT, give ISRT to 20 Gy at 2 Gy/fx
3b. If Deauville 4, consider ISRT or biopsy. If negative then continue with ISRT or if positive treat with refractory disease.
3c. If Deaville 5a, biopsy and if negative give ISRT
3d. If Deaville 5b, biopsy and if negative observe with short interval follow up.

If any biopsy is positive, treat that patient as if he/she has refractory disease

27
Q

What is the recommended treatment for Stage IA-IIA, unfavorable bulky?

A
  1. ABVD x 4 cycles and restage with PET/CT
    2a. If Deauville 1-3, treat with 2 more cycles of ABVD
  2. ISRT

2b. If deauville 4, treat with 2 more cycles of ABVD and if now Deaville 1-3 on restaging PET/CT then ISRT

28
Q

When do you get a follow up set of PFTs when delivering ABVD?

A

After the 4th cycle of bleomycin, if more is being planned

29
Q

Deaville Score 1

A

No uptake beyond background

30
Q

Deaville Score 2

A

Uptake at or below that of mediastinum

31
Q

Deaville Score 3

A

Uptake above that of mediastinum but below at or liver

32
Q

Deaville Score 4

A

Uptake moderately increased compared to liver at any site

33
Q

Deaville Score 5

A

5a. Uptake markedly increased compared to liver at any site

5b. no metastatic sites

34
Q

What is recommended treatment for Stage III-IV?

A
  1. ABVD x 2 cycles then restage with PET/CT scan
  2. If deauville 1-3 then give 4 more cycles
    3a. If CR, observe or give ISRT to initially bulky sites
    4a. If PR, give ISRT
35
Q

What is the follow up after treatment?

A

H&P every 4 months for 2 years with CBC, BMP and ESR if initially elevated
CT chest/abdomen/pelvis every 6 months for 2 years

After 2 year, do H&P every 6 months until year three when follow up becomes yearly. Continue to order labs. No imaging.

36
Q

When should annual breast screening be recommended for women treated with RT?

A

8-10 years after treatment or at age 40, whichever comes first.

Get a breast MRI and mammography for women treated with chest RT between ages 10-30.

37
Q

What alternative treatment is available for patients with Stage III-IV disease?

A

Stanford V for 12 weeks and restage with PET/CT scan
If Deaville 1-3, then treat with ISRT to 30 Gy to all sites initially 5 cm in size or greater.

If Deaville 4 ot 5a, either treat with ISRT to 36 Gy or rebiopsy and if negative treat to ISRT to 36 Gy . If the biopsy is positive treat as if there is refractory disease.

Hodgkin's Lymphoma (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions