Ganguly Lectures - review

Question 1

(9:22) translocation in what cancer?

Answer 1

CML, BCR/ABL fusion

Question 2

Ph(+) in 15-30% of ________ cancers

Answer 2

AML (adult)

Question 3

• occupies ATP binding pocket of Abl kinase domains

- prevents phosphorylation and signaling, inhibiting proliferation and survival

Answer 3

Imatinib mesylate

Question 4

2nd generation tyrosine kinase inhibitors, work for P210 and P190

Answer 4

nilotinib/dasatinib

Question 5

myeloproliferative disorders all have ______ mutations

Answer 5

JAK2

Question 6

• JAK2 inhibitor
• blocks cytokine and growth factor expression
• approved for primary myelofibrosis, PV, etc.

Answer 6

ruxolitinib

Question 7

• BTK inhibitor, blocks NF-kB

- approved for Waldenstrom’s macroglobulinemia, CLL, and Mantle Cell Lymphoma

Answer 7

Ibrutinib

Question 8

• PI3K inhibitor

- approved for CLL, Follicular lymphoma, relapes SLL

Answer 8

Idelalisib

Question 9

proteasome inhibition (bortezimib) used for what cancer?

Answer 9

multiple myeloma

Question 10

only cancer that has a 90% response?

Answer 10

imatinib for CML

Question 11

• increase antigenic epitope expression
• can act on tumor cells, NK, T, macrophages
• used for mycosis fungoides

Answer 11

interferons

Question 12

• cytokines secreted by white cells
• enhance tumor ID and killing
• used for
• IL-2 in renal cell carcinoma, GVHD

Answer 12

interleukins

Question 13

• first monoclonal antibody
• indicated for CD20(+) B cell non hodgkin Lymphoma
• CLL, ALL CD20, autoimmune
• viral reaction caution

Answer 13

rituximab

Question 14

• anti CD52 (on T and B cells)
• CLL refractory to alkylating agents and failed fludarabine
• GVH prophylaxis
• viral reaction

Answer 14

Alemtuzumab anti CD52

Question 15

• antibodies to IL-6

- if patient crashes after CAR-T therapy

Answer 15

tocilizumab

Question 16

• anti CTLA-4

- melanoma treatment

Answer 16

ipililumab

Question 17

CTLA-4 agonists used in?

Answer 17

autoimmune, allergies, transplant rejection

Question 18

Reed Sternberg cells upregulate?

Answer 18

PD-1

Question 19

• anti PD-1, checkpoint inhibitor

- relapsed refractory Hodgkin

Answer 19

nivolumab

Question 20

• CD19 (B cells) and CD3 (T cell) engages T cell to fight other arm
• ALL and non-Hodgkin

Answer 20

blinatumomab (bisepcific T cell engagin antibody) BiTE

Question 21

• anti CD30 (Hodgkin)
• with chemotoxin MMAE
• direct antibody drug conjugate

Answer 21

brentuximab

Question 22

• non Hodkins: high grade, or relapsed DLBCL
• Hodgkin’s relapsed
• multiple myeloma: first line therapy, improves survival

Answer 22

indications for autologous transplant

Question 23

• AML: intermediate or high risk (not 15/17, 8/21 or inv16)
• ALL: Ph(+), patients >60
• CML: controversial with Gleevec
• refractory non-Hodgkins (CLL, follicular, mantle cell)
• aplastic anemia <20 yo
• non malignant: thalassemias, sickle cell

Answer 23

indications for allogeneic transplant

Question 24

• naive immune system, reduced GVHD

- superior proliferative capacity compensates for small dose

Answer 24

umbilical cord blood

Question 25

highly aggressive lymphomas?

Answer 25

Burkitt’s, lymphoblastic

Question 26

aggressive lymphomas?

Answer 26

DLBCL, mantle cell

Question 27

15;17
8;21
inv16
FLT3(-)

Answer 27

good cytogenics for AML, no transplant

Question 28

FLT3(+)
-5,-7
myelodysplastic

Answer 28

high risk AML, indication for transplant

Question 29

• ascites, edema, conjugated hyperbilirubinemia

- day 21

Answer 29

veno-occlusive disease of liver (sinusoidal obstruction syndrome)

Question 30

jaundice, rash, diarrhea

Answer 30

acute GVHD

Question 31

jaundice, elevated AST, ALT

Answer 31

viral hepatitis

Question 32

antifungals, chemo, cyclosporine, TPN

Answer 32

drug toxicity