HAEMOLYMPHATIC 1 Flashcards
what are the 4 types/locations of lymphoma?
which is the most common?
multicentric [most common]
cranial mediastinal
alimentary
entranodal
multicentric lymphoma can often lead to enlargement of what organ?
hepatosplenomegaly
alimentary lymphomas can be difficult to treat due to high grade and widespread infiltration. however this does not include _________lymphomas
rectal
extranodal lymphoma of the skin can be of which two types?
-primary cutaneous?
-non-epitheliotrophic?
lymphoma paraneoplastic syndroms:
_______glycaemia
________ammaglobinaemia
first step to diagnose lymphoma is FNA/cytology. which kinda of lymphomas can NOT b diagnosed on ctyology?
small cell lymphoma
when diagnosing lymphoma using cytology, which lymph nodes should be samples?
popliteal node
[avoid submandibular due to it having frequent from dental disease]
what are 3 aspects from this cytolgoy that help diagnose it as a lymphoma?
-clumped chromatin/nucleoli
-basophilic cytoplasm[stained darkly]
-mitosis
RELISTEN TO THE PARTS ABT CYTOLOGY
what is the next step is diagnosis after FNA/cytology?
excisional biopsy
what are two types of additional diagnostics?[after biopsy] immunophenotyping and ____________
what are the 3 types of immunophenotyping?
immunophenotyping
PARR
what is immunophenotyping?
looks for specific markers on cell to diagnose lymphomas [T vs B cell, CD markers, etc]
describe how immunehistochemistry works
describe how flow cytometry works.
what is a limitation of it compared to other techniques?
what is an advantage of it compared to other techniques?
describe how PARR works
is it higher in specificity or sensitivity?
-assesses clonality in a cell population by looking at a market from T cells OR B cells
-monoclonal: neoplastic/ polyclonal: unique, non-neoplastic
-higher specificity, so neg test does NOT rule out
which haematology findings, although nonspecific, can indicate lymphoma?
neutrophilia
thrombocytopenia
lymphopenia
eosinopenia
mild non-regen anaemia
lymphocytosis
reduced cobalamin (B12)
there are more lymphomas here as well. check lecture where she circled them
along with lymph node enlargement, what are 2 things your could see on diagnostic imaging AXR of lymphoma?
-hepatosplenomegaly
-peritoneal effusion[double check why]
what is an advantage of ultrasound over AXR in lymphoma diag imaging?
-ultrasound detects involvement of other organs
-useful for FNA/biopsy guidance
which lymphoma has WORSE prognosis:
-T cell or B cell?
T cell
what are the 3 drug options for single-agent chemotherapy for lymphoma?
-which provides shortest remission/survival time?
prednisone [shortest time, 2-3 mo]
doxorubicin
lomustine
what is the main toxicity of prednisolone?
iatrogenic hyperadrenocorticism
which drug is the best to give as a single agent chemo with 70% CR and 6-7mo survival?
doxorubicin
what are some (5) toxicities of doxorubicin/epirubicin?
- SEVERE perivascular irritant
- Anaphylaxis
*acute cardiotoxicity
*cumulative, dose-dependant - Nausea
- GI effects
- Myelosuppression
- Nephrotoxicity
- Alopecia
what are two types of toxicities for loumustine?
-hepatotoxicity
-myelosuppression
What are two additional lymphoma tx drugs that can be used in multi-drug chemotherapy?
vincristine
cyclophosphamide
is vincristine phase specific? if so, which?
what are some toxicities?
M phase
-pereivascular irritant
-mylosurpressive, neurotoxicity
is cyclophosphamide phase specific? if so, which?
what are some toxicities?
-non phase specific
-myelosupression
GI upset
sterile haemorrhagic cystitis
alopecia
remission: what si the definition of PR?
CR?
which chemo drug can cross blood-brain barrier, and therefore is good for CNS relapses which are frequent?
cytosine arabinoside
is cytosine arabinoside phase specific? if so, which?
what are some (2) toxicities?
S phase
-myelosupression
-GI upset
-these toxicities greater if given by infusion
L-asparginase should be given through which route? why?
IM [not IV] due to frequent anaphylaxis
what is tumour lysis syndrome?
what si the best preventative measure?
-large tumour burden responds n undergoes lysis quickly —>intracellular components released into circulation —>hyperkalaemia, hyperphosphataemia
.
-best preventative=hydration
what is a rescue therapy?
therapy(s) given for a relapse
