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PHM703 Heme/Onc/Crit Care > Exam 3 - Lymphoma > Flashcards

Exam 3 - Lymphoma Flashcards

1
Q

List risk factors for lymphomas? (8)

A

male gender, older age (younger as well in HL), immunosuppression, infections, environmental exposures, radiation exposure, Epstein-Barr virus, HIV infection

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2
Q

Describe the epidemiology of non-Hodgkin’s lymphoma (NHL)?

A

occurs more frequently in European descent, B-cells most common

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3
Q

List signs/symptoms of diffuse large B-cell lymphomas (DLBCL)?

A

B-symptoms (fever, night sweats, significant weight loss as 10% in 6 months), nodal masses, elevated lactate dehydrogenase, bone marrow involvement, AMS

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4
Q

Which mutation is most important in diagnosing NHL?

A

CD20

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5
Q

What is preferred treatment for NHL? (2)

A

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), Pola-R-CHP (polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, prednisone)

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6
Q

What are chemotherapy considerations for CHOP and ABVD therapies? (2)

A

high emetic risk (give anti-emetic regimen prior) and consider G-CSFs in high risk patients (febrile neutropenia prevention)

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7
Q

What are AEs of CHOP therapy?

A

infections, fatigue, anemia, alopecia

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8
Q

What is the maximum lifetime anthracycline dose?

A

450-500 mg/m^2

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9
Q

What are AEs of vincristine? (2)

A

peripheral neuropathy (max 2 mg dose), constipation

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10
Q

What is an AE of cyclophosphamide?

A

hemorrhagic cystitis

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11
Q

What is the MoA of rituximab?

A

anti-CD20 moAb

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12
Q

What are AEs of rituximab? (4)

A

infusion-related reactions, hepB reactivation, hypogammaglobulinemia (GI perforations), PML

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13
Q

Explain what antibodies are present in acute/chronic HBV infection?

A

positive HBsAg, positive anti-HBc, positive/negative anti-HBc, negative antiHBs

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14
Q

What is another treatment for NHL?

A

DA-R-EPOCH (dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin)

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15
Q

When is a DA-R-EPOCH regimen the treatment of choice? What MUST be given following it?

A

double- or triple-hit B-cell lymphomas; G-CSF

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16
Q

What is the MoA of polatuzumab vedotin (Polivy)?

A

anti-CD79B conjugated to microtubule disruptor

17
Q

What are AEs of polatuzumab vedotin (Polivy)? (5)

A

myal/arthralgia, constipation, peripheral neuropathy, infusion-related reactions, anemias

18
Q

List relapse/refractory treatments for NHL? (4)

A

R-ICE (rituximab, ifosamide, carboplatin, etoposide) and GDP (gemcitabine, dexamethasone, carboplatin), autologous stem cell transplant, CAR-T, bispecific moAbs

19
Q

What is fixed-duration treatment for normal TP53* CLL/SLL?

A

venetoclax + obinutuzumab

20
Q

What is indefinite treatment for normal TP53* CLL/SLL?

A

acalabrutinib +/- obinutuzumab or zanubrutinib or ibrutinib

21
Q

What is indefinite treatment for mutated TP53* CLL/SLL?

A

acalabrutinib +/- obinutuzumab or zanubrutinib or ibrutinib

22
Q

What is fixed duration treatment for mutated TP53* CLL/SLL?

A

venetoclax + obinutuzumab

23
Q

What is the MoA of obinutizimab (Grazyva)?

A

anti-CD20 moAb (2nd gen)

24
Q

What are AEs of obinutuzumab (Gazyva)? (3)

A

infusion-related reactions, hepB reactivation, increased viral infection risk

25
Q

What is the MoA of Bruton tyrosine kinase inhibitors?

A

block B-cell receptor signaling cascade and prevent proliferation and survival of all B-cells

26
Q

What is the first generation BTKi? Second? (2)

A

ibrutinib (Imbruvica); acalbrutinib (Calquence), zanubrutinib (Brukinsa)

27
Q

What are AEs more associated with the first generation BTKi (ibrutinib)?

A

atrial fibrillation, bleeding events, diarrhea, HTN

28
Q

List signs/symptoms of Hodgkin’s lymphomas (HL)?

A

B-symptoms (fever, night sweats, weight loss), lymphadenopathy, generalized malaise

29
Q

What is treatment for Stage I/II HL?

A

ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)

30
Q

What is treatment for Stage III/IV HL? (3)

A

ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), BV+AVD (brentuximab vedotin with AVD), escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone)

31
Q

What is an AE of bleomycin?

A

pulmonary toxicity

32
Q

What is an AE of dacarbazine?

A

cytopenias

33
Q

What is the MoA of brentuximab vedotin (Adcetris)?

A

anti-CD30 conjugated to microtubule disruptor

34
Q

What are AEs of brentuximab vedotin (Adcetris)? (5)

A

pulmonary toxicity, constipation, peripheral neuropathy, infusion-related reactions, anemias

35
Q

List relapse/refractory treatments for HL? (3)

A

R-ICE (rituximab, ifosamide, carboplatin, etoposide) and GVD (gemcitabine, vinorelbine, liposomal doxorubicin), autologous stem cell transplant, immunotherapy (nivolumab, pembrolizumab)

PHM703 Heme/Onc/Crit Care (18 decks)

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