Diffuse large B cell Lymphoma

Question 1

DLBCL features

Answer 1

typically present with a rapidly enlarging symptomatic mass, most usually nodal enlargement in the neck or abdomen

fast growing
curable

2 major subtypes

• germinal center ( do well)
• activated b cell like ( do poorly)

Question 2

Staging

Answer 2

limited stage
stage 1 - single node
stage 2 - multi node same side of diaphragm
advanced stage
stage 3 - multi node both sides of diaphragm
stage 4 - metastatic disease

Question 3

Stage 2 b disease

Answer 3

bulky disease is often treated the same as advanced disease as it carries a worse prognosis

Question 4

Treatment

Answer 4

R- CHOP forms the basis of treatment

Rituximab
cylcophosphomide
hydroxydaunorubicin (doxorubicin/adriomycin)
vincristine
prednisolone

Question 5

Recurrent DLBCL

Answer 5

Auto SCT

using rituximab is controversial

Question 6

Ibrutinib

Answer 6

Receptor tyrosine kinase ihibitor
inactivates brutons tyrosine kinase

slows/ stops b cell proliferation

Question 7

Double hit lymphoma

Answer 7

BCL and Cmyc translocations (two hits)

poor prognosis
no agreed upon treatment