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Malignant Hematology > DLBCL and Burkitt Lymphoma > Flashcards

DLBCL and Burkitt Lymphoma Flashcards

1
Q

What are the 5 components to the IPI for DLBCL?

A

Age >60
LDH above ULN
ECOG 2+
Stage III or IV
Extranodal sites >1
(PALES: Performance, Age, LDH, Extranodal, Stage)

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2
Q

CD10+ helps distinguish what types of DLBCL?

A

Germinal center type is Cd10+

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3
Q

What is short course R-CHOP and who is eligible for it?

A

R-CHOP x4 followed by Rx2 (instead of R-CHOPx6)
Stage I/II, non-bulky, low risk (IPI =0)

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4
Q

MoA of Polatuzumab vedotin

A

ADC targeting CD79b
Conjugated to microtubule inhibitor

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5
Q

Pola-R-CHP is better than R-CHOP in what patients?

A

ABC subtype
High IPI
Age >60
Not bulky
–No change in OS or CR

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6
Q

Treatment for primary mediastinal large B cell lymphoma

A

DA-R-EPOCH

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7
Q

What are the genetic aberrations in double hit lymphoma?

A

MYC
BCL2

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8
Q

What are the genetic aberrations in triple hit lymphoma?

A

MYC
BCL2
BCL6

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9
Q

Treatment for double or triple hit lymphoma?

A

DA-R-EPOCH

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10
Q

What is the difference in GCB and ABC lymphoma in those with HIV or immunodeficiencies?

A

ABC has much worse prognosis, tend to be more immunosuppressed

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11
Q

Treatment for HIV-associated DLBCL

A

R-EPOCH
Ritux only when CD4>50

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12
Q

In HIV-associated DLBCL, when can you give Rituximab?

A

CD4 >50

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13
Q

What two lymphomas are commonly HHV8+

A

Primary effusion lymphoma
Multicentric Castlemans

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14
Q

Treatment for localized testicular primary LBCL?

A

Orchiectomy plus XRT to contralateral testes
Consider CNS prophylaxis

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15
Q

What work-up is needed after someone is diagnosed with primary CNS lymphoma?

A

Testicular US
Slit lamp exam
Spine MRI
BMBx

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16
Q

1L treatment for advanced DLBCL (2)

A

R-CHOP
Pola-R-CHP

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17
Q

In R/R DLBCL, how does the time from 1L therapy change the treatment algorithm?

A

If less than a year, than you determine eligibility for CAR-T
If more than 1 year, then determine eligibility for autoHCT

18
Q

R/R LBCL for fit patient who relapsed after less than 1 year after 1L? (2)

A

CAR-T
Axi-cel
Liso-cel

19
Q

Treatment for R/R LBCL in a fit patient who relapsed more than 1 year from 1L treatment.

A

Salvage chemo then autoHCT

20
Q

R/R LBCL treatment in patient relapsed more than 1 year from 1L treatment and you want to bring them to ASCT.

A

R+Chemo
RICE, R-GemOx, RGDP, R-DHAP, R-ESHAP

21
Q

CAR-T treatment options in 3L or later in DLBCL?

A

Axicaptagene
Tisaleucel
Lisocaptagene

22
Q

Chemotherapy-free regimens in R/R LBCL (3)

A

Pola-Benda-R
Tafasitumab - Len
Loncastuximab

23
Q

Two BiTE options for R/R LBCL

A

Glofitimab
Epcoritimab

24
Q

Best treatment strategy for fit patient with R/R LBCL after ASCT?

25
Treatment for R/R DLBCL in unfit patient who isn't a candidate for CAR-T or ASCT? (4)
Tafasitumab + Len Lonca-T Glofitimab Epcoritimab
26
Classic translocation in Burkitt lymphoma
t(8;14)
27
African endemic Burkitt lymphoma is associated with what disease?
EBV
28
IMmunophenotype of BUrkitt
CD19+, Cd20+, CD10+, BCL6+ TdT negative Ki67 100% Never expresses Bcl2
29
3 most common translocations in Burkitt lymphoma
8;14 8;22 2;8
30
What gene translocation is classic in Burkitt?
MYC
31
Treatment options for 1L Burkitt lymphoma (3)
R-HyperCVAD DA-EPOCH-R CODOX-M-IVAC
32
How to calculate a CNS IPI
Age >60 PS >1 Extranodal involvement >1 LDH >ULN Stage III or IV Kidney or adrenal involvement (IPI + kidney/adrenal involvement)
33
What CNS IPI score should be treated with CNS prophylaxis?
4-6
34
CNS prophylaxis options for high-risk patients (2)
IT MTX (or cytarabine) High dose MTX
35
What four types of lymphoma are at high risk of CNS invovlement?
Testicular Kidney/adrenal Primary cutaneous DLBCL, leg type Stage IE DLBCL of breast
36
Preferred treatment for AIDS related plasmablactic lymphoma? (3)
EPOCH CODOX-M/IVAC HyperCVAD
37
Treatment of stage I/II DLBCL with non-bulky disease?
R-CHOP x3, then PET-CT. If CR, then ISRT or 1 more RCHOP
38
Treatment of stage I/II DLBCL with bulky disease?
R-CHOP x3-4 cycles, then PET. If CR, then R-CHOP x2-3 more +/- ISRT
39
Treatment for R/R Primary mediastinal B cell lymphoma? (3)
Pembro Nivo +/- Bv Or like DLBCL - RICE-->Auto or CAR=T
40
1L treatment for primary mediastinal B-cell lymphoma? (2)
DA-R-EPOCH RCHOP

Malignant Hematology (13 decks)

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