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PHRM 864 Therapeutics > Exam 2 - Hematologic Malignancies I Grove > Flashcards

Exam 2 - Hematologic Malignancies I Grove Flashcards

1
Q

B-cells attack invaders ______ the cell while T-cells attack ______ cells

A

outside; infected

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2
Q

Hodgkin lymphoma (HL) is characterized by what kind of cells?

A

Reed-Sternberg cells

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3
Q

what is the backbone of lymphoma tx?

A

chemotherapy

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4
Q

what are the B symptoms? (3 of them)

A

-fever (> 38 C)
-drenching night sweats
-unintentional weight loss of greater than 10% in past 6 months or less

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5
Q

HL presentation (3 things; slide 18)

A

-painless, rubbery, enlarged lymph nodes
-B symptoms (25-50%)
-itchiness

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6
Q

best diagnosis biopsy for HL and NHL

a. excisional biopsy
b. bone marrow biopsy

A

a. excisional biopsy

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7
Q

best biopsy for advanced stage HL

a. excisional biopsy
b. bone marrow biopsy

A

b. bone marrow biopsy

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8
Q

HL classification: early-stage favorable

a. stage I-II without unfavorable factors
b. stage I-II with unfavorable factors
c. stage III-IV

A

a. stage I-II without unfavorable factors

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9
Q

HL classification: early-stage unfavorable

a. stage I-II without unfavorable factors
b. stage I-II with unfavorable factors
c. stage III-IV

A

b. stage I-II with unfavorable factors

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10
Q

HL classification: advanced stage

a. stage I-II without unfavorable factors
b. stage I-II with unfavorable factors
c. stage III-IV

A

c. stage III-IV

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11
Q

look up unfavorable factors (slide 21)

A

okay

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12
Q

what score is used to measure risk factors for stage III to IV HL?

A

international prognostic score (IPS)

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13
Q

goal for HL tx

a. palliative
b. cure

A

b. cure

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14
Q

what is autologous stem cell transplant?

A

high dose chemotherapy with stem cell rescue

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15
Q

what are the two chemo regimens for HL? (slide 25)
what drugs are included in these regimens?

A

-ABVD = doxarubicin, bleomycin, vinblastine, dacarbazine
-AAVD = doxarubicin, brentuximab vendotin, vinblastine, dacarbazine

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16
Q

AAVD should be used in which stages of HL?

A

stage III/IV

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17
Q

T or F: the ABVD regimen has low rates of neutropenia and high infection rates

A

F (high neutropenia, low infection)

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18
Q

relapsed HL tx (2 things to know; slide 27)

A

-autologous stem cell transplant
-maintenance therapy if high risk relapse with brentuximab vendotin following stem cell transplant

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19
Q

how many cycles of ABVD chemo for early stage HL? (range)

A

2-4

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20
Q

how many cycles of ABVD or AAVD for advanced stage HL? (range)

A

6-8

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21
Q

NHL (Non Hodgkin Lymphoma) pathophysiology (2 things to know; slide 33)

A

-malignant B or T lymphocytes and precursors
-malignant cells proliferate and replace normal cells in lymph nodes and/or bone marrow

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22
Q

what percent of NHL is due to B-cells vs T-cells?

A

B cells: ~85-90%
T cells: ~10-15%

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23
Q

which is NOT an infection that is a risk factor for NHL?

a. rhinovirus
b. Epstein-Barr virus
c. Human T-cell lymphotropic virus type 1
d. Human herpes virus 8
e. helicobacter pylori

A

a. rhinovirus

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24
Q

NHL presentation if it is due to B-cells

a. lymph nodes, spleen, bone marrow
b. extra nodal sites (skin and lungs)

A

a. lymph nodes, spleen, bone marrow

25
Q

NHL presentation if it is due to T-cells

a. lymph nodes, spleen, bone marrow
b. extra nodal sites (skin and lungs)

A

b. extra nodal sites (skin and lungs)

26
Q

look at slide 37 for differences between HL and NHL

27
Q

NHL diagnosis for pt with sx or high-risk disease

a. excisional biopsy
b. CT or PET
c. bone marrow biopsy
d. lumbar puncture

A

d. lumbar puncture

28
Q

follicular lymphoma first line tx (2 regimens)

A

-BR = bendamustine + rituximab
-R-CHOP = rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

29
Q

follicular lymphomas can transform into an aggressive NHL know as _______ _______

A

Richter’s transformation

30
Q

T or F: chemotherapy on Richter’s transformation will get rid of all underlying follicular lymphomas

A

F (yields 40% CR of the DBLCL but still have underlying follicular lymphomas)

31
Q

most common type of NHL

A

diffuse large B-cell lymphoma (DLBCL)

32
Q

R-CHOP most common toxicities

a. diarrhea
b. neutropenia
c. N/V
d. anemia

A

b. neutropenia

33
Q

HepB and which drug can cause risk of viral reactivation?

A

rituximab (so check for HBsAg and HBcAb before starting)

34
Q

pre-emptive tx for pt who tests positive for HBsAg or HBcAb prior to starting rituximab

a. entecavir
b. acyclovir
c. valacyclovir

A

a. entecavir

35
Q

tx for anti-CD20 antibody late neutropenia

A

gram colony stimulating factors (G-CSF)

36
Q

relapsed DLBCL/aggressive NHL tx options (4 of them)

A

-autologous stem cell rescue
-CAR-T therapy
-bendamustine + rituximab + polatuzumab
-BiTEs

37
Q

know how CAR-T therapy works (slide 57-59)

38
Q

two BiTEs for third line aggressive NHL

A

-eprocitamab
-glofitamab

39
Q

BiTEs and CAR-T cell therapy can cause what two unique toxicities? (slide 63)

A

-cytokine release syndrome (CRS)
-immune effector cell-associated neurotoxicity syndrome (ICANS)

40
Q

_____ gene translocation is present in nearly all cases of Burkitt’s Lymphoma

a. BCL2
b. BCL6
c. MYC

41
Q

multiple myeloma pathophysiology (from internet; 3 things to know)

A

-plasma cells become cancerous and multiply uncontrollably
-these plasma cells and MM cells accumulate in bone marrow
-abnormal M protein is produced and causes various complications

42
Q

multiple myeloma presentation acronym

A

CRAB = hypercalcemia, renal dysfunc, anemia, bone lesions

C = calcium > 11.5
R = renal; SCr > 2 mg/dL or CrCl < 40 mL/min
A = anemia; Hgb < 10 g/dL or 2 g/dL below normal
B = bone; one or more osteolytic lesions or pathologic fracture

43
Q

MM tx overview (3 steps)

A

-induction
-consolidation
-maintenance

44
Q

what is the first question for MM induction therapy?

A

is pt a transplant candidate?

45
Q

MM induction therapy: pt should be on a ___ drug regimen if they are NOT a transplant candidate

46
Q

MM induction therapy: pt should be on a ___ drug regimen for ___-___ cycles if they are a transplant candidate

47
Q

what drug class is backbone of MM tx?

48
Q

look at MM agents for 3 drug regimen (slide 89)

49
Q

monoclonal antibodies daratumumab and isatuximab are anti-_____ mAbs

a. CD3
b. CD19
c. CD20
d. CD38

50
Q

target for elotuzumab

51
Q

look at preferred induction regimens for MM (slide 95)

52
Q

what drugs are in the VRD regimen for MM?

A

bortezomib
lenalidomide
dexamethasone

53
Q

look at relapsed/refractory MM tx (slide 101)

54
Q

two CAR-T agents for MM

A

idecabtagene vicleucel (Abecma)
ciltacabtagene autoleucel (Carvykti)

55
Q

CAR-T therapy for MM is indicated after 4 or more prior lines of therapy. What drug classes are on the slide? (slide 102)

A

-proteasome inhibitor
-immunomodulatory agent
-anti-CD38 mAb

56
Q

there is an inc risk of HSV infections with ________ ________ or ________ ________

A

proteasome inhibitor; monoclonal antibody

57
Q

what two drugs can be used for prophylaxis of HSV infections in MM?

A

acyclovir, valacyclovir

58
Q

VTE is highest in first ___ months of diagnosis of MM

59
Q

aspirin 81-325 mg daily can be used for prophylaxis of ___ risk VTE in MM

a. high
b. low

PHRM 864 Therapeutics (28 decks)

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