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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?

A

CAR-T

25
Q

Treatment for R/R DLBCL in unfit patient who isn’t a candidate for CAR-T or ASCT? (4)

A

Tafasitumab + Len
Lonca-T
Glofitimab
Epcoritimab

26
Q

Classic translocation in Burkitt lymphoma

A

t(8;14)

27
Q

African endemic Burkitt lymphoma is associated with what disease?

A

EBV

28
Q

IMmunophenotype of BUrkitt

A

CD19+, Cd20+, CD10+, BCL6+
TdT negative
Ki67 100%
Never expresses Bcl2

29
Q

3 most common translocations in Burkitt lymphoma

A

8;14
8;22
2;8

30
Q

What gene translocation is classic in Burkitt?

A

MYC

31
Q

Treatment options for 1L Burkitt lymphoma (3)

A

R-HyperCVAD
DA-EPOCH-R
CODOX-M-IVAC

32
Q

How to calculate a CNS IPI

A

Age >60
PS >1
Extranodal involvement >1
LDH >ULN
Stage III or IV
Kidney or adrenal involvement
(IPI + kidney/adrenal involvement)

33
Q

What CNS IPI score should be treated with CNS prophylaxis?

A

4-6

34
Q

CNS prophylaxis options for high-risk patients (2)

A

IT MTX (or cytarabine)
High dose MTX

35
Q

What four types of lymphoma are at high risk of CNS invovlement?

A

Testicular
Kidney/adrenal
Primary cutaneous DLBCL, leg type
Stage IE DLBCL of breast

36
Q

Preferred treatment for AIDS related plasmablactic lymphoma? (3)

A

EPOCH
CODOX-M/IVAC
HyperCVAD

37
Q

Treatment of stage I/II DLBCL with non-bulky disease?

A

R-CHOP x3, then PET-CT. If CR, then ISRT or 1 more RCHOP

38
Q

Treatment of stage I/II DLBCL with bulky disease?

A

R-CHOP x3-4 cycles, then PET. If CR, then R-CHOP x2-3 more +/- ISRT

39
Q

Treatment for R/R Primary mediastinal B cell lymphoma? (3)

A

Pembro
Nivo +/- Bv
Or like DLBCL - RICE–>Auto or CAR=T

40
Q

1L treatment for primary mediastinal B-cell lymphoma? (2)

A

DA-R-EPOCH
RCHOP

Malignant Hematology (13 decks)

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