Hubbard - WBC Flashcards
ATRA is used for?
Methotrexate used for
Maintenance of AML only
Maintenance of ALL
Ommaya reservoir is adventageous when/how?
For leptomeningeal disease, when chemo does not pass through the BBB into the CSF. Better than lumbar puncture.
-Catheter inserted into lateral ventricle for intrathecal therapy.
Symptoms of leukemic meningitis
N/HA due to leptomeningeal infiltration. Use Ommaya reservoir.
For AML, when do you give antibiotics for feveR?
Even if the cause is not found, give broad spectrum.
G-CSF and CM-CSF given for what?
after completion of AML chemo (ATRA?), shortens period of severe myelosuppression.
Leukostasis in CML - s/s; cause, appears during what phases?
- Dyspnea, drwsiness, loss of coordination, confusion
- Caused by leukocyte sludging into pulmonary (lungs)/cerebral vessels.
- Appears during accelerated and blastic phase of CML.
Dx of CML
- Anemia + SM in 30-50%; LUQ fullness and early satiety.
- Leukocytosis with low LAP. Hypercellular bone marrow with myeloid hyperplasia.
Cytogenetics of CML.
t(9;22)
When is imatinib used in CML? What type of drug is this?
To decrease development of accelerated or blastic phase.
It is a TKI, first line therapy.
Middle aged white man, + pancytopenia + SM +nonaspirable marrow
HCL
TRAP
Treatment of HCL
- Mild cytopenia, no infection hx, marrow infiltration low = NO THERAPY
- First line = ADI
- Relapses = rituximab
Rai staging
0 = excellent prognosis
3, 4 = anemia an dthrombocytopenia, worse prognosis (have Hb
Clinical manifestations of NHL
Lymphadenopathy +/- compression related presentations (i.e. SVC sydnrome w/distended superficial veins)
-firm and NT
Dx of lymphoma - use what (2)
Staging of lymphoma - use what (1)
- Fine needle aspirate - DO NOT USE
- Excisional Biopsy (preferred for initial diagnosis) –> use Core Needle Biopsy for primary diagnosis (if pt has heart condition/cannot be put under anesthesia)
- CT imaging
Burkitt requires what in addition to tx?
CNS prophylaxis + intrathecal chemo or high-dose methotrexate
