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Heme/Onc word association Flashcards

1
Q

blood loss from GI, pallor, easy fatigability. PICA, Plummer-Vinson synd. Smear shows hypochromic microcytic, target cells. Plasma ferritin low. Tx: ferrous sulfate

A

Iron def anemia

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2
Q

gene deletion. Smear show acathrocytes for minor and poikilocytes for major. Retic increased. Tx: folic acid suppl

A

Thalassemia A

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3
Q

point mutation. Shows up 4-6 months with HSM and jaundice. Minor has Hgb A2 on Hgb electro and basophilic stippling on smear. Major has poikilocytes and baso stippling on smear, low hct. Tx: blood transfusion

A

Thalassemia B

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4
Q

organ failure. Normochromic normocytic. Increased iron stores and serum ferritin. Serum iron and trasnferrin extremely low. Tx: underlying dz

A

Anemia of chronic dz

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5
Q

T cell mediated autoimmune suppression of hematopoiesis

A

Impaired BM fxn

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6
Q

purpura, pancytopenia. Tx: mild=transfusion of RBC and platelets. Severe= BM transplant or immunosupp

A

Aplastic anemia

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7
Q

low WBC, BM needed for dx

A

Myelodysplastic syndrome

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8
Q

acquired. Caused by myelodysplasia. BM= ringed sideroblasts. Fe increased. Smear is norm and hypochromic cells. Tx: blood transfusion

A

Sideroblastic anemia

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9
Q

frailty, muscle weakness, impaired cog fxn. Hgb>10. Tx: tx cause

A

Elderly anemia

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10
Q

poor diet. Common with MTX and phenytoin. Sore tongue. Smear= macro-ovalocytes and hypersegmented polymorphonuclear cells. Howell-Jolly bodies. Tx: PO folic acid

A

Folic acid defic

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11
Q

pernicious anemia. Neuro damage. Absorbed in terminal ileum. Neuro= parasthesias, ataxia, confusion. Retic reduced. B12 decreased. Tx: B12 supplementation

A

B12 def

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12
Q

RBC destruction. Rapid onset jaundice and infection with parvo B19. Retic elevated. Smear= teardrop cells and target cells. Coombs +. High serum LDH. Tx: glucocorticoids

A

Hemolytic anemia

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13
Q

RBC short life span. AVN of femoral head. Painful crisis. Electro Hgb S in cells. Smear= Howell-Jolly. Retic elevated. Tx: analgesics, hydroxyurea. Splenectomy

A

Sickle cell anemia

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14
Q

x-linked, black. Oxidative stress and infection. Retic elevated, indir bili increased. Smear=Heinz bodies. Tx: self limited

A

G6PD defic

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15
Q
A

Neutropenia

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16
Q

>10,000. Secondary.

A

Leukocytosis

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17
Q

plt

A

Thrombocytopenia

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18
Q

myeloid cells>350,000. WBC inc. caused by infx, inflame, Fe def, B12 def, alcohol,Ca. tx: ASA, Anticoags. Essential throm= hydroxyurea, anagrelide, interfereon

A

Thrombocytosis

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19
Q

autoimmune destruction of spleen. Sx= mucosal bleed, after viral illness. Low plt and slightly enlarged. BM= megakaryocytes. Evan’s syndrome smear= anemia, reticulocytosis and spherocytosis. Tx: prednisone, splenectomy

A

ITP

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20
Q

non-immune. Pentat= fever, neuro, renal fail, microangiopathic hemolytic anemia and inc serum LDH. Smear= fragmented RBC. Reduced protease. Elevated Indir bili and elevated LDH. Tx: Lg Vol plasmapheresis

A

TTP

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21
Q

kids after diarrhea. Adults who take estrogen. RBC frag. Elevated LDH. Renal bx= necrosis and thrombi. Tx: conservative mgmt.

A

HUS

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22
Q

non-immune plt. Life threatening. Caused by sepsis, severe tiss injury, bad proteins. Trousseau synd. Hypofibrinogenemia, plt low, prolonged PT. fragmented RBC. Tx: tx underlying illness, platelet transfusion.

A

DIC

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23
Q

elevated RBC count. 60y male. Most common result of thrombosis. May lead to myelofibrosis. Wears out BM. Sx= splenomegaly, inc blood viscosity and volume. PE= plethora. Smear= neutrophilic leukocytosis, inc basophils and eosinophils. Iron stores absent. JAK2+ and EPO low.tx: phlebotomy, ASA daily, hydrea

A

Primary polycythemia

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24
Q

elevated RBC count. 60 y male. Most common result of thrombosis. May lead to myelofibrosis. Caused by chronic hypoxia, circulating factor EPO, pulm dz. Sx= splenomegaly, inc blood viscosity and volume. PE= plethora. Smear= neutrophilic leukocytosis, inc basophils and eosinophils. Iron stores absent. Elevated EPO. Tx: phlebotomy, ASA daily, hydrea

A

Secondary Polycethemia

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25
Q

excess all cell lines. Sx=Splenomegaly, arterial/venous thrombosis. HCT above normal, JAK2 +. Tx: phlebotomy, low Fe diet

A

Polycythemia vera

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26
Q

excess plt prod. Sx: thrombosis. Smear=large plt. BM= inc number megakaryocytes. Tx: Hydroxyurea

A

Essential thombocythemia

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27
Q

fibrosis of marrow. Sx= abd fullness, hepatomegaly. Smear= tear-drop pikylocytosis, leukoerythroblastic blood and giant degranulated plt. Tx: supportive

A

Myelofibrosis

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28
Q

reduced factor8. Sx= bleeding. Tx: desmopressin and factor 8

A

Von Willebrand dz

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29
Q

factor 8. X-linked. Sx= spont hem episodes. Prolonged aPTT. Tx= desmopressin and factor8

A

Hemophilia A

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30
Q

factor 9. Tx: fresh frozen plasma

A

Hemophilia B

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31
Q

sx= Post Op. PT and aPTT prolonged. Factor 2,7,9,10 decreased. Tx: vit K, fresh frozen plasma

A

Vit K dependent deficiencies

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32
Q

ACS 7 warning signs of cancer

A

CAUTION Change in bowel or bladder habits. A sore that does not heal. Unusual bleeding or discharge. Thickening of lump in breast or elsewhere. Indigestion or difficulty in swallowing. Obvious change in wart or mole. Nagging cough or hoarseness

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33
Q

low socioeconomic status, physical inactivity. Age. Screen at 50 y up to

A

Colorectal CA

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34
Q

sx= nipple discharge, skin changes. Mammo show microcalcifications. Tx= breast conserving therapies with radiation, mastectomy

A

Breast CA

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35
Q

>40y DRE. Sx= hesitancy, dribbling, urgency, nocturia. PSA elevated. Tx= active surveillance, prostatectomy

A

Prostate CA

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36
Q

adenocarcinoma. Sx= hoarsness, hemoptysis. CXR first modality.

A

Lung CA

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37
Q

in apex of lung= extreme numbness and arm pain

A

Pancost

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38
Q

derived from endocrine cells. Sx= present late . tx: chemo

A

Small cell

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39
Q

adenocarcinoma, smoking association. Central. Sx= ulcerate and bleed and bronchial obstruction. Tx: surgery

A

Non-small cell

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40
Q

sx= constipation, fatigue, anorexia. Tx= saline hydration, glucocorticoids

A

Hypercalcemia

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41
Q

sx= anorexia, confusion, depression, lethargy. Tx= water restriction, demeclocycline

A

SIADH

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42
Q

sx= anorexia, ortho hypotension. Tx= IV cortisone

A

Adrenal insuff

43
Q

sx= facial swelling, dyspnea, dilated neck veins, collateral chest wall veins. CXR= widened superior mediastinum. Tx= ONC emergency. Radiation to shrink and anticoags

A

SVC syndrome

44
Q

sx= back pain with point tenderness, incontinence, weakness, +Babinski sign. XR= winking owl. Tx= Onc emergency= radiation, dexamethasone

A

Spinal cord compression

45
Q

WBC

A

Febrile neutropenia

46
Q

proliferation of immature myeloid cells. Sx= gingival hyperplasia, recurrent infx, bone pain. Adults >60y. Pancytopenia with circulating blasts. BM bx confirms. Auer rods. BM= hypercellular. Tx= combo chemo

47
Q

lymphoid stem cells in BM that invade lymph neds. Sx= bone pain in long bones, lymphadenopathy, hepatosplenomegaly. Kids 3-7 y. Pancytopenia with circulating blasts. BM bx confirms. CXR= mediasstinal mass. Term deoxy trans. Philadelphia chrom +. Tx= combo chemo

48
Q

prolif of immature granulocytes. Sx= abd fullness, splenomegaly, hepatomegaly. 30-50y. inc number of granulocytes. Philadelphia chrom +. Smear= smudge cells. BM= hypercellular with L shift. Tx= Gleevec- tyrosine kinase inhibitor

49
Q

mature B lymphocytes that invade BM. Sx= periph lymphocytosis, splenomegaly and lymphadenopathy. Richter’s synd= isolated node transforms to aggressive. Men >50y. Lymphocytosis with leukocytosis. Smear show anemia and thrombocytosis. BM= well differentiated lymphocytes. Chrom abnorm(tri 21). Tx= Binet staging= A(no tx), B(alkylating agent and radiation), C(chlorambucil with prednisone)

50
Q

enlargement of lymphoid tissue. Reed-Sternberg Cells. Women 20-40 y >50y. sx= painless cervical, supraclavicular and mediastinal lymphadenopathy, excessive night sweating. Bx show Reed-sternberg cells. Tx= combo chemo, radiation therapy.

51
Q

group of malig that arise from lymphocytes. B lymphocytes. >50ysx= diffuse or isolated, painless, persistent lymphadenopathy. Bx done for dx. Tx= single node(radiation), low grade(rituximab), aggressive(allogeneic transplant), high grade(chemo and stem cell)

A

Non-hodgkin lymphoma

52
Q

malig of plasma cells d/t herpes virus. Bone destruction and can lead to spinal cord compression. Recurrent infx. Paraprotein levels are increased. 65y, men, black. Sx= bone pain. Monoclonal gammopathy on serum or urine protein electro. Xr= lytic lesions. Tx= Lenalidomide, dexamethasone and doxorubicin. Bisphos as adjunct.

A

Multiple myeloma

53
Q

Disease to information

Iron def anemia

A

blood loss from GI, pallor, easy fatigability. PICA, Plummer-Vinson synd. Smear shows hypochromic microcytic, target cells. Plasma ferritin low. Tx: ferrous sulfate

54
Q

Disease to information

Thalassemia A

A

gene deletion. Smear show acathrocytes for minor and poikilocytes for major. Retic increased. Tx: folic acid suppl

55
Q

Disease to information

Thalassemia B

A

point mutation. Shows up 4-6 months with HSM and jaundice. Minor has Hgb A2 on Hgb electro and basophilic stippling on smear. Major has poikilocytes and baso stippling on smear, low hct. Tx: blood transfusion

56
Q

Disease to information

Anemia of chronic dz

A

organ failure. Normochromic normocytic. Increased iron stores and serum ferritin. Serum iron and trasnferrin extremely low. Tx: underlying dz

57
Q

Disease to information

Impaired BM fxn

A

T cell mediated autoimmune suppression of hematopoiesis

58
Q

Disease to information

Aplastic anemia

A

purpura, pancytopenia. Tx: mild=transfusion of RBC and platelets. Severe= BM transplant or immunosupp

59
Q

Disease to information

Myelodysplastic syndrome

A

low WBC, BM needed for dx

60
Q

Disease to information

Sideroblastic anemia

A

acquired. Caused by myelodysplasia. BM= ringed sideroblasts. Fe increased. Smear is norm and hypochromic cells. Tx: blood transfusion

61
Q

Disease to information

Elderly anemia

A

frailty, muscle weakness, impaired cog fxn. Hgb>10. Tx: tx cause

62
Q

Disease to information

Folic acid defic

A

poor diet. Common with MTX and phenytoin. Sore tongue. Smear= macro-ovalocytes and hypersegmented polymorphonuclear cells. Howell-Jolly bodies. Tx: PO folic acid

63
Q

Disease to information

B12 def

A

pernicious anemia. Neuro damage. Absorbed in terminal ileum. Neuro= parasthesias, ataxia, confusion. Retic reduced. B12 decreased. Tx: B12 supplementation

64
Q

Disease to information

Hemolytic anemia

A

RBC destruction. Rapid onset jaundice and infection with parvo B19. Retic elevated. Smear= teardrop cells and target cells. Coombs +. High serum LDH. Tx: glucocorticoids

65
Q

Disease to information

Sickle cell anemia

A

RBC short life span. AVN of femoral head. Painful crisis. Electro Hgb S in cells. Smear= Howell-Jolly. Retic elevated. Tx: analgesics, hydroxyurea. Splenectomy

66
Q

Disease to information

G6PD defic

A

x-linked, black. Oxidative stress and infection. Retic elevated, indir bili increased. Smear=Heinz bodies. Tx: self limited

67
Q

Disease to information

Neutropenia

68
Q

Disease to information

Leukocytosis

A

>10,000. Secondary.

69
Q

Disease to information

Thrombocytopenia

70
Q

Disease to information

Thrombocytosis

A

myeloid cells>350,000. WBC inc. caused by infx, inflame, Fe def, B12 def, alcohol,Ca. tx: ASA, Anticoags. Essential throm= hydroxyurea, anagrelide, interfereon

71
Q

Disease to information

ITP

A

autoimmune destruction of spleen. Sx= mucosal bleed, after viral illness. Low plt and slightly enlarged. BM= megakaryocytes. Evan’s syndrome smear= anemia, reticulocytosis and spherocytosis. Tx: prednisone, splenectomy

72
Q

Disease to information

TTP

A

non-immune. Pentat= fever, neuro, renal fail, microangiopathic hemolytic anemia and inc serum LDH. Smear= fragmented RBC. Reduced protease. Elevated Indir bili and elevated LDH. Tx: Lg Vol plasmapheresis

73
Q

Disease to information

HUS

A

kids after diarrhea. Adults who take estrogen. RBC frag. Elevated LDH. Renal bx= necrosis and thrombi. Tx: conservative mgmt.

74
Q

Disease to information

DIC

A

non-immune plt. Life threatening. Caused by sepsis, severe tiss injury, bad proteins. Trousseau synd. Hypofibrinogenemia, plt low, prolonged PT. fragmented RBC. Tx: tx underlying illness, platelet transfusion.

75
Q

Disease to information

Primary polycythemia

A

elevated RBC count. 60y male. Most common result of thrombosis. May lead to myelofibrosis. Wears out BM. Sx= splenomegaly, inc blood viscosity and volume. PE= plethora. Smear= neutrophilic leukocytosis, inc basophils and eosinophils. Iron stores absent. JAK2+ and EPO low.tx: phlebotomy, ASA daily, hydrea

76
Q

Disease to information

Secondary Polycethemia

A

elevated RBC count. 60 y male. Most common result of thrombosis. May lead to myelofibrosis. Caused by chronic hypoxia, circulating factor EPO, pulm dz. Sx= splenomegaly, inc blood viscosity and volume. PE= plethora. Smear= neutrophilic leukocytosis, inc basophils and eosinophils. Iron stores absent. Elevated EPO. Tx: phlebotomy, ASA daily, hydrea

77
Q

Disease to information

Polycythemia vera

A

excess all cell lines. Sx=Splenomegaly, arterial/venous thrombosis. HCT above normal, JAK2 +. Tx: phlebotomy, low Fe diet

78
Q

Disease to information

Essential thombocythemia

A

excess plt prod. Sx: thrombosis. Smear=large plt. BM= inc number megakaryocytes. Tx: Hydroxyurea

79
Q

Disease to information

Myelofibrosis

A

fibrosis of marrow. Sx= abd fullness, hepatomegaly. Smear= tear-drop pikylocytosis, leukoerythroblastic blood and giant degranulated plt. Tx: supportive

80
Q

Disease to information

Von Willebrand dz

A

reduced factor8. Sx= bleeding. Tx: desmopressin and factor 8

81
Q

Disease to information

Hemophilia A

A

factor 8. X-linked. Sx= spont hem episodes. Prolonged aPTT. Tx= desmopressin and factor8

82
Q

Disease to information

Hemophilia B

A

factor 9. Tx: fresh frozen plasma

83
Q

Disease to information

Vit K dependent deficiencies

A

sx= Post Op. PT and aPTT prolonged. Factor 2,7,9,10 decreased. Tx: vit K, fresh frozen plasma

84
Q

Disease to information

CAUTION Change in bowel or bladder habits. A sore that does not heal. Unusual bleeding or discharge. Thickening of lump in breast or elsewhere. Indigestion or difficulty in swallowing. Obvious change in wart or mole. Nagging cough or hoarseness

A

ACS 7 warning signs of cancer

85
Q

Disease to information

Colorectal CA

A

low socioeconomic status, physical inactivity. Age. Screen at 50 y up to

86
Q

Disease to information

Breast CA

A

sx= nipple discharge, skin changes. Mammo show microcalcifications. Tx= breast conserving therapies with radiation, mastectomy

87
Q

Disease to information

Prostate CA

A

>40y DRE. Sx= hesitancy, dribbling, urgency, nocturia. PSA elevated. Tx= active surveillance, prostatectomy

88
Q

Disease to information

Lung CA

A

adenocarcinoma. Sx= hoarsness, hemoptysis. CXR first modality.

89
Q

Disease to information

Pancost

A

in apex of lung= extreme numbness and arm pain

90
Q

Disease to information

Small cell

A

derived from endocrine cells. Sx= present late . tx: chemo

91
Q

Disease to information

Non-small cell

A

adenocarcinoma, smoking association. Central. Sx= ulcerate and bleed and bronchial obstruction. Tx: surgery

92
Q

Disease to information

Hypercalcemia

A

sx= constipation, fatigue, anorexia. Tx= saline hydration, glucocorticoids

93
Q

Disease to information

SIADH

A

sx= anorexia, confusion, depression, lethargy. Tx= water restriction, demeclocycline

94
Q

Disease to information

Adrenal insuff

A

sx= anorexia, ortho hypotension. Tx= IV cortisone

95
Q

Disease to information

SVC syndrome

A

sx= facial swelling, dyspnea, dilated neck veins, collateral chest wall veins. CXR= widened superior mediastinum. Tx= ONC emergency. Radiation to shrink and anticoags

96
Q

Disease to information

Spinal cord compression

A

sx= back pain with point tenderness, incontinence, weakness, +Babinski sign. XR= winking owl. Tx= Onc emergency= radiation, dexamethasone

97
Q

Disease to information

Febrile neutropenia

98
Q

Disease to information

AML

A

proliferation of immature myeloid cells. Sx= gingival hyperplasia, recurrent infx, bone pain. Adults >60y. Pancytopenia with circulating blasts. BM bx confirms. Auer rods. BM= hypercellular. Tx= combo chemo

99
Q

Disease to information

ALL

A

lymphoid stem cells in BM that invade lymph neds. Sx= bone pain in long bones, lymphadenopathy, hepatosplenomegaly. Kids 3-7 y. Pancytopenia with circulating blasts. BM bx confirms. CXR= mediasstinal mass. Term deoxy trans. Philadelphia chrom +. Tx= combo chemo

100
Q

Disease to information

CML

A

prolif of immature granulocytes. Sx= abd fullness, splenomegaly, hepatomegaly. 30-50y. inc number of granulocytes. Philadelphia chrom +. Smear= smudge cells. BM= hypercellular with L shift. Tx= Gleevec- tyrosine kinase inhibitor

101
Q

Disease to information

CLL

A

mature B lymphocytes that invade BM. Sx= periph lymphocytosis, splenomegaly and lymphadenopathy. Richter’s synd= isolated node transforms to aggressive. Men >50y. Lymphocytosis with leukocytosis. Smear show anemia and thrombocytosis. BM= well differentiated lymphocytes. Chrom abnorm(tri 21). Tx= Binet staging= A(no tx), B(alkylating agent and radiation), C(chlorambucil with prednisone)

102
Q

Disease to information

Hodkin dz

A

enlargement of lymphoid tissue. Reed-Sternberg Cells. Women 20-40 y >50y. sx= painless cervical, supraclavicular and mediastinal lymphadenopathy, excessive night sweating. Bx show Reed-sternberg cells. Tx= combo chemo, radiation therapy.

103
Q

Disease to information

Non-hodgkin lymphoma

A

group of malig that arise from lymphocytes. B lymphocytes. >50ysx= diffuse or isolated, painless, persistent lymphadenopathy. Bx done for dx. Tx= single node(radiation), low grade(rituximab), aggressive(allogeneic transplant), high grade(chemo and stem cell)

104
Q

Disease to information

Multiple myeloma

A

malig of plasma cells d/t herpes virus. Bone destruction and can lead to spinal cord compression. Recurrent infx. Paraprotein levels are increased. 65y, men, black. Sx= bone pain. Monoclonal gammopathy on serum or urine protein electro. Xr= lytic lesions. Tx= Lenalidomide, dexamethasone and doxorubicin. Bisphos as adjunct.

DOOS 2 (6 decks)

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