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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
how many cycles of chemo in HL early stage and late stage
2-4 cycles 6-8 cycles
26
which HL therapy preferred for younger pts
AAVD
27
if patient on ABVD or AAVD for HL gets neutropenic what do you do?
continue on therapy, they wont get sick
28
median age Non-Hodgkin lymphoma
68
29
5 year survival rate Non hodkin
74%
30
Non-Hodgkin lymphoma risk factors
epstein barre virus human herpes virus 8 H. pylori AIDS autoimmune disease
31
fever defined as what
greater than 38 degree celcius
32
symptoms of Non Hodgkin lymphoma
B cell symptoms organ dysfunction
33
diagnosis of Non Hodgkin lymphoma how
excisional biopsy
34
which type of B cell lymphomas are usually curable
indolent (slow growing)
35
follicular lymphoma is what
2nd most common NHL indolent
36
follicular lymphoma do we treat?
not unless patient preference, chemo was same outcome
37
follicular lymphoma can turn into what
aggressive NHL (Richters transformation)
38
diffuse large b cell lymphoma (NHL) has what genetic abnormalities that increase aggressiveness
double hit/triple hit MYC, BCL2, BCL6 translocations (low survival)
39
diffuse large cell b lymphoma treatment stage I-II
R-CHOP + Radiation therapy (3 cycles) R-CHOP (6 cycles) (most)
40
diffuse large B cell lymphoma treatment stage III-IV
6 cycles R-CHOP 6 cycles pola+r+chop if IPI >2
41
R-CHOP is what
retuximab doxorubicin based
42
pola + r + chip
polatuzumab retuximab doxorubicin
43
CHOP toxicity
neutropenia
44
polar chip only for what pts
IPI >= 2, high risk
45
what happens if we treat DLBCL that was originally follicular lymphoma
it will still have underlying follicular lymphoma
46
retuximab targets what
CD20
47
CAR-T cells and Bites target what
CD19
48
classic treatment non-hodgkin lymphoma
R-CHOP rituximab cyclophosphamide doxorubicin vincristine prednisone
49
if at high risk neutropenia what will we give older pts with R-CHOP
growth factors
50
if giving retuximab what are pts are increased risk for
hep B reoccurance
51
how can we check for HepB past
Hep B surface antigen and core antibody
52
if Hep B surface antigen or core antibody was positive what do we do
entecavir 0.5 mg once daily before
53
if pts get late neuropenia what can we give
gram colony stimulating factors IVIg
54
if relapsed DLBCL/aggressive nhl what do we give for curative intent
salvage chemo followed by autologous stem cell rescue CART
55
how does CAR-T work
T cell recognizes cancer in the body and activates immnue respons (turn back on the T cells)
56
what do t cells target
CD19
57
BITE drugs
epcoritamab glofitamab CD3 on T and CD20 on B cells
58
are Bites patient specific
no, they bring the T cell to the cancer
59
CART and BITE toxicities
cytokine release syndrome (CRS) immune effector cell associated neurotoxicity syndrome (ICANS)
60
drug to treat cytokine release syndrome for CART
tocilizumab add steroid if needed
61
ICANS symptom
hand writing
62
multiple myeloma is a disease of what cells
plasma cells
63
malignant myeloma cells secrete what
60% IgG 20% IgA 20% light chain only
64
when do we start treating multiple myeloma
once we get to symptoms
65
CRAB symtpoms
calcium > 11.5 renal dysfunct SCR >2 CrCl <40 anemia Hg < 10 or 2 below norm bone: osteo lesions
66
is multiple myeloma curable
no
67
multiple myeloma treatment
if transplant candidate: autologous transplant if not: 3 drug regimen followed by stem cell harvest once can tolerate
68
multiple myeloma drugs
STEROIDS lenalidomide zomib
69
cornerstone of MM treatment
high dose chemo induction consolidation - autologous stem cell transplant maintenance

PHRM 864 (28 decks)

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