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Medical Oncology SCE > Haematological cancers > Flashcards

Haematological cancers Flashcards

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USMLE® Step 1 flashcards
1
Q

Which gene fusion is commonly seen in CML?

A

BCR:ABL

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2
Q

Which haematological maligancy is 12 times more likely to affect patients with HIV?

A

Non-hodgkins lymphoma

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3
Q

What is the broad mechanism of CAR-T cell therapy?

A

T cells are genetically engineered and a manufacture Chimeric antigen receptor is added which allows T cells to directly present to cell surface antigens

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4
Q

What is the broad mechanism of TIL therapy?

A

Tumour infiltrating lymphocytes are removed from the patient and expanded and/or engineered prior to infusion back into the patient.

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5
Q

What is the standard of care for diffuse large B cell lymphoma? How would the treatment change if patient above 80 years or significant comorbidity?

A

R - CHOP, otherwise (R) mini chop.

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6
Q

What is luspatercept used for?

A

Anaemia in MDS and beta thalassaemia

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7
Q

What is the most common subtype of Hodgkin lymphoma?

A

Nodule sclerosis

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8
Q

First line treatment of CLL with 17p deletion or TP53 mutation

A

Ibrutinib or Zanubrutinib

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9
Q

Which mutation in CLL is correlated with a very good clinical outcome

A

Del 13q 14

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10
Q

Which drugs commonly cause cytokine release syndrome and how would you treat it?

A

Bispecific T cell antibody, CAR-T.
Give tocilizumab, steroids used in refractory cases.

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11
Q

What is a useful investigation in the context of CAR-T cell therapy neurotoxicity?

A

EEG

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12
Q

What should be considered in patients with abdo pain and diarrhoea post ablative chemotherapy (arabinoside, cytarabine or idarubin)

A

Necrotising or neutropenic enterocolitis

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13
Q

What mutation is correlated with improved prognosis in CLL?

A

Mutated immunoglobulin heavy chain variable regions

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14
Q

Name 4 poor prognostic mutations in CLL

A

Del17p
High Beta 2 microglobulin (B2M)
TP53 mutation
High ZAP-70 levels

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15
Q

What are the 3 phases of CML?

A

Chronic- blast levels<10%
Accelerated phase- blast levels 10-19%
Blast phase- blast levels >20%

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16
Q

Dasatanib is a drug used to treat CML. What is its unusual side effect?

A

Pleural effusions (in 20%)

17
Q

What is rasburicase

A

Recombinant urate oxidase used to treat TLS.

18
Q

Which cell surface marker pattern would you expect to see in Hodgkin Lymphoma?

A

CD20 negative (65%), CD30 positive (almost always), CD15 positive (80%)

19
Q

What is the SOC for newly diagnosed DLBCL?

A

RCHOP

20
Q

How would you modify the RCHOP regime if patient was >80yo or it’s cardiac dysfunction or frail?

A

Omit or substitute doxorubicin

21
Q

Hodgkin lymphoma is usually staged via which classification?

A

Lugano

22
Q

What does the A or B classification mean in Lugano classification for HL?

A

Presence (B) or absence (A) of B symptoms

23
Q

Broadly speaking define stage III and stage IV HL?

A

Involved nodes on both sides of the diaphragm in stage 3. Stage 4 is extranodal disease.

24
Q

What is the management of relapsed or refractory DLBCL?

A

R-GDP (or R-DHAP and R-ICE) follows by high dose chemotherapy with autologous stem cell transplant

25
Q

What is the most common haematological malignancy to occur as a later effect of treatment with alkylating agents?

A

AML
Usually high WCC, anaemia and thrombocytopenia

26
Q

What is the immediate management of patients with acute promyelocytic leukaemiaV

A

All-trans retinoic acid is warranted (distinguished by high proportion to promyelocytes in WCC)

27
Q

In a patient with suspected CML (high WCC, normal plt/Hb with immature granulocytes on blood film) how would a diagnosis be reached?

A

Bone marrow aspirate with full karyotypic analysis

28
Q

What is the usual first line management of follicular lymphomaC

A

Watch and wait

29
Q

What is the first line treatment for Philadelphia positive CML?

A

Imatinib

30
Q

What is the most common mechanism of hypercalcaemia in HL?

A

Production of calcitriol (also seen in 1/3 of non Hodgkin lymphoma)

31
Q

Overexpression is cyclin D1 gene is associated with which haematological malignancy?

A

Mantle cell lymphoma

Medical Oncology SCE (27 decks)

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