hodgkins lymphoma

Question 1

signs and symptoms

Answer 1

• lymph node enlargement
• B symptoms
• Splenomgegaly

Question 2

Cell morphology

Answer 2

Reed Sternberg cell

Question 3

Staging

Answer 3

1- single node
2- multi nodes same side of diaphragm
3- multi nodes both side of diaphragm
4- metastatic disease

Question 4

Treatment

Answer 4

Stage 1 and 2 = radiotherapy and chemotherapy (ABVD)
Stage 3 and 4 = ABVD vs BEACOPP

Adriamycin (doxorubicin)
bleomycin
vinblastine
dacarbazine

high cure rate. long survival times. concern has now focused on drug toxicity.

Question 5

Relapsed hodgkins disease

Answer 5

1. ) autologous stem cell transplant
2. ) *** Brentuximab, new agent, buys time, not curative
3. ) *** Nivolumab, not yet listed on PBS, not curative

Question 6

Adriamycin (doxorubicin)

Answer 6

Doxorubicin stabilizes the topoisomerase II complex after it has broken the DNA chain for replication, preventing the DNA double helix from being resealed and thereby stopping the process of replication

Main side effect is cardiomyopathy leading to HF

Question 7

Bleomycin

Answer 7

Bleomycin acts by induction of DNA strand breaks

Side effect = pulmonary fibrosis

Question 8

Vinblastine

Answer 8

inhibits microtubule formation

side effects - hair loss

Question 9

dacarbazine

Answer 9

Dacarbazine works by methylating guanine at the O-6 and N-7 positions.uanine is one of the four nucleotides that makes up DNA. The alkylated DNA strands stick together such that cell division becomes impossible

Question 10

Brentuximab

Answer 10

antibody against CD30 linked to vedotin.
commonly expressed on hodgkins lymphoma
used to treat relapses

buys time
non curative

Question 11

Nivolumab

Answer 11

Nivolumab acts by blocking a negative regulator of T-cell activation and response, thus allowing the immune system to attack the tumor

PD-1 is a protein on the surface of activated T cells. If another molecule, called programmed cell death 1 ligand 1 or programmed cell death 1 ligand 2 (PD-L1 or PD-L2), binds to PD-1, the T cell becomes inactive. This is one way that the body regulates the immune system, to avoid an overreaction. Many cancer cells make PD-L1, which inhibits T cells from attacking the tumor.

Used primarily to treat melanoma
shown to be effective in hodgkins lymphoma