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PHRM 864 > Heme > Flashcards

Heme Flashcards

1
Q

name the myeloid malignancies (3)

A

chronic myeloid leukemia
acute myeloid leukemia
myelodysplastic syndrome

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2
Q

name the lymphoid malignancies (5)

A

Hodgkin Lymphoma
Non-Hodgkin Lymphoma
chronic lymphocytic leukemia
acute lymphocytic leukemia
multiple myeloma

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3
Q

hematologic malignancies occur where

A

blood
bone marrow
lymph nodes

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4
Q

B and T cells come from what

A

lymphoid stem cell

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5
Q

eosinophils, neutrophils, RBCs come from what

A

myeloid stem cell

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6
Q

Hodgkin lymphoma characterized by what

A

Reed-Sternberg cells

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7
Q

90% of Non-Hodgkin lymphoma are what type of cell

A

B cell

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8
Q

HL survival if untreated and treated

A

90% fatal in 2-3 years if not treated
89% if treated

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9
Q

median age HL

A

39 years

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10
Q

how do we find the Reed Sternberg cells?

A

take out the whole lymph node

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11
Q

symptoms of Hodgkin lymphoma

A

B symptoms: fever
sweats
weight loss >10% in < 6 month
pruritis
painful enlarged lymph node

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12
Q

diagnosis of HL how

A

excisional biopsy to find Reed Sternberg cells

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13
Q

early stage favorable

A

stage I-II without unfavorable factors

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14
Q

early stage unfavorable

A

stage I-II with unfavorable factors

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15
Q

advanced stage

A

III-IV

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16
Q

unfavorable factors

A

multiple nodal regions
B symptoms
extranodal involvement
ESR

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17
Q

Hodgkin Lymphoma treatment goal

A

cure

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18
Q

what is an autologous stem cell transplant

A

give pt really high dose chemo then give them their bone marrow back to rescue

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19
Q

ABVD treatment HL

A

doxorubicin
bleomycin
vinblastine
dacarbazine

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20
Q

regimen if we dont use bleomycin (AAVD)

A

doxorubicin
brentuximab
vinblastine
dacarbazine

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21
Q

bleomycin causes what toxicity

A

pulmonary toxicity

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22
Q

relapsed Hodgkin lymphoma treatment

A

high dose chemo then autologous stem cell rescue

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23
Q

maintenance therapy for Hodgkin lymphoma

A

brentuximab

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24
Q

who should get maintenance brentuximab for HL

A

high risk relapse following stem cell transplant

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25
Q

how many cycles of chemo in HL early stage and late stage

A

2-4 cycles
6-8 cycles

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26
Q

which HL therapy preferred for younger pts

A

AAVD

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27
Q

if patient on ABVD or AAVD for HL gets neutropenic what do you do?

A

continue on therapy, they wont get sick

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28
Q

median age Non-Hodgkin lymphoma

A

68

29
Q

5 year survival rate Non hodkin

A

74%

30
Q

Non-Hodgkin lymphoma risk factors

A

epstein barre virus
human herpes virus 8
H. pylori
AIDS
autoimmune disease

31
Q

fever defined as what

A

greater than 38 degree celcius

32
Q

symptoms of Non Hodgkin lymphoma

A

B cell symptoms
organ dysfunction

33
Q

diagnosis of Non Hodgkin lymphoma how

A

excisional biopsy

34
Q

which type of B cell lymphomas are usually curable

A

indolent (slow growing)

35
Q

follicular lymphoma is what

A

2nd most common NHL
indolent

36
Q

follicular lymphoma do we treat?

A

not unless patient preference, chemo was same outcome

37
Q

follicular lymphoma can turn into what

A

aggressive NHL
(Richters transformation)

38
Q

diffuse large b cell lymphoma (NHL) has what genetic abnormalities that increase aggressiveness

A

double hit/triple hit
MYC, BCL2, BCL6 translocations
(low survival)

39
Q

diffuse large cell b lymphoma treatment stage I-II

A

R-CHOP + Radiation therapy (3 cycles)
R-CHOP (6 cycles) (most)

40
Q

diffuse large B cell lymphoma treatment stage III-IV

A

6 cycles R-CHOP
6 cycles pola+r+chop if IPI >2

41
Q

R-CHOP is what

A

retuximab
doxorubicin based

42
Q

pola + r + chip

A

polatuzumab
retuximab
doxorubicin

43
Q

CHOP toxicity

A

neutropenia

44
Q

polar chip only for what pts

A

IPI >= 2, high risk

45
Q

what happens if we treat DLBCL that was originally follicular lymphoma

A

it will still have underlying follicular lymphoma

46
Q

retuximab targets what

A

CD20

47
Q

CAR-T cells and Bites target what

A

CD19

48
Q

classic treatment non-hodgkin lymphoma

A

R-CHOP
rituximab
cyclophosphamide
doxorubicin
vincristine
prednisone

49
Q

if at high risk neutropenia what will we give older pts with R-CHOP

A

growth factors

50
Q

if giving retuximab what are pts are increased risk for

A

hep B reoccurance

51
Q

how can we check for HepB past

A

Hep B surface antigen and core antibody

52
Q

if Hep B surface antigen or core antibody was positive what do we do

A

entecavir 0.5 mg once daily before

53
Q

if pts get late neuropenia what can we give

A

gram colony stimulating factors
IVIg

54
Q

if relapsed DLBCL/aggressive nhl what do we give for curative intent

A

salvage chemo followed by autologous stem cell rescue
CART

55
Q

how does CAR-T work

A

T cell recognizes cancer in the body and activates immnue respons (turn back on the T cells)

56
Q

what do t cells target

A

CD19

57
Q

BITE drugs

A

epcoritamab
glofitamab
CD3 on T and CD20 on B cells

58
Q

are Bites patient specific

A

no, they bring the T cell to the cancer

59
Q

CART and BITE toxicities

A

cytokine release syndrome (CRS)
immune effector cell associated neurotoxicity syndrome (ICANS)

60
Q

drug to treat cytokine release syndrome for CART

A

tocilizumab
add steroid if needed

61
Q

ICANS symptom

A

hand writing

62
Q

multiple myeloma is a disease of what cells

A

plasma cells

63
Q

malignant myeloma cells secrete what

A

60% IgG
20% IgA
20% light chain only

64
Q

when do we start treating multiple myeloma

A

once we get to symptoms

65
Q

CRAB symtpoms

A

calcium > 11.5
renal dysfunct SCR >2 CrCl <40
anemia Hg < 10 or 2 below norm
bone: osteo lesions

66
Q

is multiple myeloma curable

A

no

67
Q

multiple myeloma treatment

A

if transplant candidate: autologous transplant
if not: 3 drug regimen
followed by stem cell harvest once can tolerate

68
Q

multiple myeloma drugs

A

STEROIDS
lenalidomide
zomib

69
Q

cornerstone of MM treatment

A

high dose chemo induction
consolidation - autologous stem cell transplant
maintenance

PHRM 864 (23 decks)

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