FL, MZL, and MCL

Question 1

Immunophenotype of Follicular lymphoma

Answer 1

CD10+ CD20+ BCL2+

Question 2

Characteristic translocation of FL?

Answer 2

t(14;18)

Question 3

What is the difference in treatment of FL3A and FL3B

Answer 3

3B is treated like DLBCL

Question 4

What are components of the FLIPI (5)

Answer 4

4+ nodal sites
LDH above ULN
Age >60
Stage III-IV
Hemoglobin <12

Question 5

What does the addition of X to lymphoma stage mean?

Answer 5

Bulky disease (>10 cm)

Question 6

When to treat newly diagnosed FL?

Answer 6

Essentially symptomatic patients or those with consequences like cytopenias, elevated LDH
Nodes >3cm in 3 areas, LNs or tumor >7 cm

Question 7

Treatment for Stage I/II FL?

Answer 7

IFRT 24 Gy

Question 8

What is the effect of treating asymptomatic patients with advanced FL with Rituximab?

Answer 8

Improves PFS but not OS
This is why observation is an option

Question 9

What is the effect of maintenance Rituximab in advanced FL for those initially treated with Ritux x4?

Answer 9

Improves PFS but no difference in OS

Question 10

What is the preferred treatment for symptomatic advanced FL? (2)

Answer 10

Benda + Rituximab (better PFS than R-CHOP)
Ritux + Len

Question 11

MoA of Tazemetostat

Answer 11

EZH2 inhibitor

Question 12

Approved BiTEs for 3L FL? (2)

Answer 12

Mosenetuzumab
Epcoritimab

Question 13

Approved CAR-T for R/R FL? (2)

Answer 13

Axicabtagene ciloleucel
Tisagenlucleucel

Question 14

Immunophenotype fo Marginal Zone Lymphoma

Answer 14

CD5- CD10- CD23- BCL6- CyclinD1-
CD19+ CD20+ CD79a+

Question 15

What are common etiologies of extranodal marginal zone lymphoma?

Answer 15

Antigen-drive disease. Often GI infections (especially MALT lymphoma)
H pylori,. Campylobacter, Borrelia, Chlamydia psittaci, hashimoto thyroiditis

Question 16

What feature of gastric extranodal marginal zone lymphoma predicts for resistance to H pylori eradication?

Answer 16

t(11;18)

Question 17

You have a patient with gastric ENMZL and treat with H pylori eradication. When to repeat endoscopy/biopsy?

Answer 17

at least 3 months

Question 18

R/R MZL treatment options (2)

Answer 18

Ibrutinib
Zanubrutinib

Question 19

Classic translocation in Mantle cell lymphoma?

Answer 19

t(11;14)

Question 20

Immunophenotype of Mantle cell lymphoma

Answer 20

CD5+. CD19+, CD20+, Cyclin D1+, FMC7+, SOX11+
CD23-

Question 21

Induction treatment for young/fit patient with mantle cell lymphoma? (3)

Answer 21

R-HyperCVAD
R-CHOP
Nordic regimen (R-maxiCHOP/R-AraC)

Question 22

Induction Treatment for older/unfit patient with mantle cell lymphoma

Answer 22

BR
R CHOP
Len-R

Question 23

Treatment options for R/R Mantle cell (6)

Answer 23

Acala
Zanubritinib
Pirtobrutinib
Ritux - Len
Venetoclax
CAR-T

Question 24

What therapy can be done after autoSCT to improve survival in patients with Mantle cell?

Answer 24

Maintenance RItux for 3 years

Question 25

Treatment of splenic MZL?

Answer 25

Rituximab Can offer splenectomy to some

Question 26

Patient with splenic MZL also has active HCV and is symptomatic from lymphoma. Treatment?

Answer 26

Treat the HCV - good chance of regression. If it doesn't then can try Ritux

Question 27

4 less intensive induction treatment regimens for MCL?

Answer 27

BR RCHOP R - Len R- Acal

Question 28

Preferred second line treatment for MCL? (2)

Answer 28

Acal Zanubritinib

Question 29

Preferred treatment for primary effusion lymphoma? (2)

Answer 29

R-EPOCH R-CHOP

Question 30

Who should you not give Bendamustine + Ritux (or obina) to in the 2L setting FL?

Answer 30

Those that got prior Benda

Question 31

2L options for fit patients with R/R FL? (4)

Answer 31

BR or BO RCHOP or OCHOP RCVP or OCVP R-Len

Question 32

What are the two most common markers for INDOLENT mantle cell lymphoma?

Answer 32

SOX11 negative IGHV mutated

Question 33

2L options for fit patients with FL (4)

Answer 33

BR or BO (unless prior benda) RCHOP, OCHOP RCVP, OCVP R-Len

Question 34

3L or subsequent lines for R/R FL (7)

Answer 34

Epcoritamab Mosunetuzumab Tazemetostat Axi-cel Tisa-cel Liso-cel Zanu+Obin

Question 35

Two CAR-T products approved for R/R Mantle Cell?

Answer 35

Liso-cel Brexucabtagene autoleucel

Question 36

Which BTKi is approved with Obinutuzumab for the treatment of R/R FL?

Answer 36

Zanubrutinib