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hemato-onco > behandelingen > Flashcards

behandelingen Flashcards

1
Q

ferriprieve anemie

A

PO Fe

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2
Q

megaloblastische anemie

A

Vit B12 + FZ!!
als je niet zeker bent van wat de oorzaak is, sowieso allebei tegelijk geven!
(als je alleen FZ geeft zonder vit B12 bij een vit B12 tekort, dan kunnen de neurologische symptomen erger worden)

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3
Q

vit B12 tekort

A

denk aan GI problemen!

-> hydroxycobalamine IM

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4
Q

FZ tekort

A

denk aan dieet!!

FZ PO + dieet aanpassen

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5
Q

anemie door renale insuff

A

EPO + Fe (IV/PO)

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6
Q

ACD

A

onderliggende aandoening

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7
Q

WAIHA

A
  • steroiden
  • anti-CD20
  • splenectomie
  • immunosuppresiva
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8
Q

KAIHA

A

koude vermijden
vaak zelflimiterend
anti-CD20
behandel onderliggende ziekte

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9
Q

hereditaire sferocytose

A

FZ

splenectomie

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10
Q

PNH

A

FZ+Fe
eculizumab
allo-STx

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11
Q

pyruvaat kinase deficientie

A

FZ

splenectomie

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12
Q

G6PD deficientie

A

oxidatieve stress vermijden

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13
Q

sikkelcelanemie

A

preventief: FZ, uitlokkende factoren vermijden
complicaties: O2, vocht, AB, analgetica
causaal: hydrea, transfusie, STx, gentherapie

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14
Q

thalassemie major

A

transfusie
allogene STx
gentherapie

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15
Q

thalassemie intermedia

A

FZ + complicaties opvolgen

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16
Q

thalassemie minor

A

geen Fe supplementen!!!

+ genetische counseling bij kinderwens

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17
Q

ITP

A 
corticoiden, IV Ig
anti-CD20
splenectomie
transfusie
TPO-R agonist
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18
Q

TTP

A

plasma-uitwisseling
corticoiden
anti-CD20

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19
Q

HUS

A

conservatief
AB
soms tijdelijk diayse

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20
Q

aHUS

A

levenslang anti-CD5 (eculizumab)

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21
Q

fanconi

A

supportief
androgenen, G-CSF
allogene STx
screening maligniteiten

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22
Q

dyskeratosis congenita

A

androgenen, G-CSF
allogene STx
screening maligniteiten

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23
Q

Schwachman diamond

A

exogene pancreasenzymen
supportieve transfusies
allogene STx

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24
Q

balckfan diamond

A

spontane remissie
corticoiden
supp transfusies
allogene STx

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25
Q

GATA2 deficientie

A

monitoring + preventie infecties
monitoring evolutie MDS/AML
allogene STx
familiale counseling

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26
Q

non-severe AA

A

afwachten

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27
Q

severe AA

A

<40j + donor -> allogene STx
>40j of geen donor -> immuunsuppressie (corticoiden + cyclosporine + antithymocytglobuline 6m + elthrombopag)
ouderen: cyclosporine, elthrombopag

28
Q

low risk MDS

A

transfusie volgens nood

transfusie nood beperken: EPO, luspatercept, lenalidomide

29
Q

high risk MDS

A

supportief
azacytidine
allogene STx

30
Q

klassieke PNH

A

FZ, Fe
transfusies
eculizumab
(anti-co)

31
Q

aplastische PNH

A

FZ
transfusies
cyclosporine
allogene STx

32
Q

CML

A

TKI

heel soms allogene STx bij blijvend therapiefalen

33
Q

polycythemia vera

A 
acuut: aderlating
chronisch
- aspirine
- CV hygiene
- low risk (<60j): periodieke aderlating
- high risk (>60j): hydroxyurea, JAK2-inh, interferon
34
Q

essentiele thrombocythemie

A 
acuut: aderlating
chronisch
- aspirine
- CV hygiene
- low risk:afwachten
- high risk: hydroxyurea, anagrelide, interferon
35
Q

myelofibrose

A

ifv leeftijd + prognostische score

  • afwachtend
  • supportief (transfusie, EPO)
  • JAK2-inh
  • hydroxyurea
  • allogene STx
36
Q

CLL

A

cytoreductie
supportief
behandeling complicaties

37
Q

CLL <65 + goede conditie

A

fludarabenide + cyclosporine + anti-CD20 om de 4w IV

38
Q

CLL oudere patienten

A

ibrutinib goed verdragen

39
Q

hairy cell variant

A

geen behandeling -> slechte prognose

40
Q

hairy cell leukemia

A

goede prognose als behandeld

41
Q

T-PLL

A

antiCD52 + allogene STx

42
Q

LGL

A

afwachten
ernstige cytopenie: CS, cyclofosfamide, cyclosporine, methotrexaat
infectie -> GF

43
Q

stadium I-II gunstig Hodgkin

A

2x chemo + radio

44
Q

stadium I-II ongunstig Hodgkin

A

2x chemo + 2-4x chemo +/- radio

45
Q

stadium III-IV hodgkin

A

2x chemo + 4x chemo +/- radio

46
Q

herval/ geen complete metabole remissie bij Hodgkin?

A 
chemo + (autologe)STx
immunotherapie
- anti-CD30
- immune checkpoint inh
-( allogene STx)
47
Q

non-Hodgkin

A

Chemo + rituximab

kijken naar mate van ziekte reductie/eradicatie en impact van ziekte en behandeling

48
Q

laaggradig non-hodgkin zonder klachten

A

afwachten

49
Q

laaggradig non-hodgkin met klachten

A

eenvoudige immunotherapie schema’s

50
Q

agressief NHL

A

altijd intensieve immuno-chemo

51
Q

intermediair NHL

A

intensieve immunochemo

52
Q

herval NHL

A

autologe/allogene STx

CAR-T

53
Q

cytoreductie MM

A 
steroiden 
hoge dosis chemo
immunomodulerende middelen (-imid)
proteasoom inhibitoren  (-omid)
monoclonale AS (daratumumab)

-> nu CS + imid/omid (evt. + autologe STx)

54
Q

herval MM

A

2e lijn: daratumumab

hogere lijnen: allogene STx, CAR-T

55
Q

ziekte van Waldenstorm

A

plasmaferese
immunotherapie
ibrutinib

56
Q

acute leukemie

A

remissie inductie
consolidatie
onderhoud

57
Q

remissie inductie acute leukemie

A

chemo + doelgerichte therapie ! hoog risico tumor lysis syndroom!
+ supportief

58
Q

niet curatieve behandeling AML

A

hypomethylerende agentia

+ BH3 mimetica (venetoclax)

59
Q

niet curatieve behandeling ALL

A

TKI (als Ph(+))

60
Q

ABO mismatch

A 
stop transfusie!!!
vocht
corticoiden
adrenaline
\+ investigatie
61
Q

TACO

A

diuretica

PC traag toedienen

62
Q

chronische transfusie

A

EPO, luspatercept en aanpak van secundaire anemie aanpakken -> transfusie nood beperken

!! Fe stappeling -> ferritine opvolgen + chelatie

63
Q

TRALI

A

supportief

64
Q

T-lymfopenie

A

VZV en PJP profylaxe

65
Q

B-lymfopenie

A

Ig’s profylaxe

hemato-onco (4 decks)

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