FL, MZL, and MCL Flashcards
Immunophenotype of Follicular lymphoma
CD10+ CD20+ BCL2+
Characteristic translocation of FL?
t(14;18)
What is the difference in treatment of FL3A and FL3B
3B is treated like DLBCL
What are components of the FLIPI (5)
4+ nodal sites
LDH above ULN
Age >60
Stage III-IV
Hemoglobin <12
What does the addition of X to lymphoma stage mean?
Bulky disease (>10 cm)
When to treat newly diagnosed FL?
Essentially symptomatic patients or those with consequences like cytopenias, elevated LDH
Nodes >3cm in 3 areas, LNs or tumor >7 cm
Treatment for Stage I/II FL?
IFRT 24 Gy
What is the effect of treating asymptomatic patients with advanced FL with Rituximab?
Improves PFS but not OS
This is why observation is an option
What is the effect of maintenance Rituximab in advanced FL for those initially treated with Ritux x4?
Improves PFS but no difference in OS
What is the preferred treatment for symptomatic advanced FL? (2)
Benda + Rituximab (better PFS than R-CHOP)
Ritux + Len
MoA of Tazemetostat
EZH2 inhibitor
Approved BiTEs for 3L FL? (2)
Mosenetuzumab
Epcoritimab
Approved CAR-T for R/R FL? (2)
Axicabtagene ciloleucel
Tisagenlucleucel
Immunophenotype fo Marginal Zone Lymphoma
CD5- CD10- CD23- BCL6- CyclinD1-
CD19+ CD20+ CD79a+
What are common etiologies of extranodal marginal zone lymphoma?
Antigen-drive disease. Often GI infections (especially MALT lymphoma)
H pylori,. Campylobacter, Borrelia, Chlamydia psittaci, hashimoto thyroiditis
What feature of gastric extranodal marginal zone lymphoma predicts for resistance to H pylori eradication?
t(11;18)
You have a patient with gastric ENMZL and treat with H pylori eradication. When to repeat endoscopy/biopsy?
at least 3 months
R/R MZL treatment options (2)
Ibrutinib
Zanubrutinib
Classic translocation in Mantle cell lymphoma?
t(11;14)
Immunophenotype of Mantle cell lymphoma
CD5+. CD19+, CD20+, Cyclin D1+, FMC7+, SOX11+
CD23-
Induction treatment for young/fit patient with mantle cell lymphoma? (3)
R-HyperCVAD
R-CHOP
Nordic regimen (R-maxiCHOP/R-AraC)
Induction Treatment for older/unfit patient with mantle cell lymphoma
BR
R CHOP
Len-R
Treatment options for R/R Mantle cell (6)
Acala
Zanubritinib
Pirtobrutinib
Ritux - Len
Venetoclax
CAR-T
What therapy can be done after autoSCT to improve survival in patients with Mantle cell?
Maintenance RItux for 3 years
Treatment of splenic MZL?
Rituximab
Can offer splenectomy to some
Patient with splenic MZL also has active HCV and is symptomatic from lymphoma. Treatment?
Treat the HCV - good chance of regression. If it doesn’t then can try Ritux
4 less intensive induction treatment regimens for MCL?
BR
RCHOP
R - Len
R- Acal
Preferred second line treatment for MCL? (2)
Acal
Zanubritinib
Preferred treatment for primary effusion lymphoma? (2)
R-EPOCH
R-CHOP
Who should you not give Bendamustine + Ritux (or obina) to in the 2L setting FL?
Those that got prior Benda
2L options for fit patients with R/R FL? (4)
BR or BO
RCHOP or OCHOP
RCVP or OCVP
R-Len
What are the two most common markers for INDOLENT mantle cell lymphoma?
SOX11 negative
IGHV mutated
2L options for fit patients with FL (4)
BR or BO (unless prior benda)
RCHOP, OCHOP
RCVP, OCVP
R-Len
3L or subsequent lines for R/R FL (7)
Epcoritamab
Mosunetuzumab
Tazemetostat
Axi-cel
Tisa-cel
Liso-cel
Zanu+Obin
Two CAR-T products approved for R/R Mantle Cell?
Liso-cel
Brexucabtagene autoleucel
Which BTKi is approved with Obinutuzumab for the treatment of R/R FL?
Zanubrutinib
