DLBCL

Question 1

Cell of origin with worse prognosis

Answer 1

Non-GCB (ABC)

Question 2

Cell of origin associated with double hit lymphoma

Answer 2

*Double hit = almost exclusively GCB origin

Question 3

DLBCL immunophenotype

Answer 3

• pan B cell antigens (CD19, CD20, CD22, CD79a)
• as well as CD45

Question 4

IPI score factors

Answer 4

APLES
A - age>60
P - PS, ECOG>2
L - elevated LDH
E - extranodal involvement
S - stage III or IV

Question 5

General staging of lymphoma

Answer 5

I - single group of lymph nodes
II - multiple groups but same side of diaphragm
III - both sides of diaphragm
IV - extranodal sites

Question 6

Limited stage DLBCL management

Answer 6

RCHOP 3-6 cycles
Consolidate radiation to sites of bulky disease

Question 7

relapsed refractory DLBCL

Answer 7

• used to be salvage chemo then auto-HSCT
• now CAR-T

Question 8

Polatuzumab mechanism

Answer 8

CD79b-directed ADC

Question 9

tafasitimab mechanism

Answer 9

anti-CD19 monoclonal ab

Question 10

Loncastuximab mechanism

Answer 10

anti-CD19 ADC

Question 11

Primary mediastinal DLBCL management

Answer 11

da-EPOCH-R, aggressive, similar to double hit

Question 12

HIV positive DLBCL management

Answer 12

More intensive chemo, like da-EPOCH-R (CONFIRM)

Question 13

CAR-T approved for DLBCL

Answer 13

• axi-cel
• liso-cel

Question 14

Paraneoplastic complications of high grade lymphoma/DLBCL

Answer 14

• hemolytic anemia
• ITP
  *nephrotic syndrome

Question 15

MUM status in GCB vs. ABC subtypes

Answer 15

ABC subtype = MUM1+
GC subtype = MUM1-

Question 16

Gene mutations in germinal center-type

Answer 16

BCL6
EZH2
Histone acetyltransferases

Question 17

Gene mutations in ABC type

Answer 17

mutations in B-cell receptor pathway lead to unchecked activation of NFkB

Question 18

Main SE of polatuzumab

Answer 18

Neuropathy

Question 19

Primary mediastinal large b-cell lymphoma clinical features + 2) complications

Answer 19

• large mediastinal mass
  in a young patient
  *commonly associated with thrombosis and SVC syndrome

Question 20

Firstline for primary mediastinal large b-cell lymphoma

Answer 20

DA-EPOCH-R

Question 21

Cell of origin for double hit

Answer 21

GCB

Question 22

Firstline for HIV-associated DLBCL

Answer 22

EPOCH

Question 23

Virus associated with primary effusion lymphoma

Answer 23

HHV8

Question 24

Virus associated with multicentric Castleman’s disease

Answer 24

HHV8

Question 25

Management of localized primary testicular large b cell lymphoma

Answer 25

Orchiectomy + XRT to contralateral testes

Question 26

Management of patient with history of hep B prior to treatment with serologies showing hep b surface antigen positive, surface antibody negative, core antigen positive

Answer 26

entecavir

Question 27

Limited stage DLBCL management

Answer 27

R-CHOP for 3-6 cycles depending on risk stratification *Favorable risk treated with 4 cycles

Question 28

Second line for DLBCL

Answer 28

IF >1 year out from treatment, salvage chemo with transplant
IF refractory disease (less than 1 year), CAR-T

Question 29

Approved CAR-T approved for DLBCL

Answer 29

• axi-cel
• liso-cel

Question 30

Third line options for DLBCL

Answer 30

IF fit and relapsed after ASCT, CAR-T
IF not fit,
- pola-r-bendamustine
- loncastuximab
- tafa-len

Question 31

Glofitimab mechanism

Answer 31

CD20xCD3 bispecific

Question 32

epicoritimab mechanism

Answer 32

CD20xCD3 bispecific

Question 33

Management of DLBCL pt with EOT PET/CT showing residual uptake that is biopsy confirmed residual disease

Answer 33

CAR-T if eligible