Lecture 11 Lymphoproliferative Disorders Flashcards
Name systemic (B) symptoms of lymphoma
Weight loss Fever Night sweats Pruritis Fatigue
What is Acute Lymphoblastic Leukaemia
Cancerous disorders of lymphoid progenitor
Is there any differentiation into lymphocytes in ALL
No
Just uncontrolled growth and accumulation
Describe the clinical presentation of ALL
Impaired vision Weight loss Breathlessness 2-3 week joint pain Bone pain Sweats Infections
What do the lab investigations look like for someone with ALL
Low Hb Elevated WCC (blast cells) Low platelets Bone marrow failure Bone marrow is 90% B-lymphocytes
What are the characteristics of ALL cells
Large cells
Express CD19- b cells
CD34, TDT- markers of immature cells
How is ALL treated
Chemo- remission Consolidation therapy CNS directed treatment SCT- high risk CART
What are the side effects of CART
Cytokine release syndrome
Neurotoxicity
What are poor risk factors for ALL
Increasing age
Increased WCC
Cytogenetics/molecular genetics t(9;22); t(4;11)
Slow/poor response to treatment
How is ALL treated
Multi-agent intensive chemo
Allogenic SCT
What are the characteristics of abnormal cells in Chronic Lymphoid Leukaemia
Mature
Resemble normal lymphocytes
Grow slowly (low-grade)
What is the common clinical presentation of CLL
Bone marrow failure (thrombocytopenia, anaemia)
Lymphadenopathy
Splenomegaly
Fever and sweats
Less common: hepatomegaly, infections weight loss
Name CLL associated finding
Haemolytic anaemia
What is stage A CLL
<3 lymph nodes areas
What is stage B CLL
3 or more lymph node areas
What is Stage C CLL
Stage B + anaemia and thrombocytopenia
How is CLL treated
Watch and wait
Cytotoxic chemo- Fludarbine
Monoclonal antibodies- Rituximab
What are indication for treatment for CLL
Progressive bone marrow failure Massive lymphadenopathy progressive splenomegaly Systemic symptoms Autoimmune cytopenias
What are poor prognostic markers for CLL
Advanced disease (B or C) Atypical lymphocyte morphology rapid lymphocyte doubling CD38+ expression P53 mutation
What are the clinical presentations of lymphoma
B symptoms
Lymphadenopathy/heptaosplenomegaly
Extranodal disease
Bone marrow involvement
In the staging of lymphoma what des “A” mean
Absence of B symptoms
In the staging of lymphoma what does “B” mean
Fever, weight loss, night sweats, pruritus
Majority of Non-hodgkin lymphoma have what cell origin
B cell
What type of Non-hodgkin lymphoma has a better prognosis
High grade
Required combination chemotherapy
What is the commonest subtype of lymphoma
Diffuse large-B cell lymphoma
High grade
What is the 2nd most common subtype of lymphoma
Follicular
Low grade
If Follicular lymphoma is not causing any problems what is the first line treatment
Watch and wait
What is the treatment for follicular and diffuse large B cell lymphoma
anti-CD20 monoclonal antibody + chemo
What virus is Hodgkin lymphoma associated with
Epstein Barr virus
HIV
How is Hodgkin Lymphoma treated
Combination therapy +/- radiotherapy
Monoclonal antibodies (CD30)
Immunotherapy
What are the most commonest symptoms of Hodgkin lymphoma
Swelling in the neck, armpit or groin
What is stage 1 HL
the cancer is limited to 1 group of lymph nodes, such as your neck or groin nodes either above or below your diaphragm (the sheet of muscle underneath the lungs)
What is stage 2 HL
2 or more lymph node groups are affected, either above or below the diaphragm
What is stage 3 HL
the cancer has spread to lymph node groups above and below the diaphragm
What is stage 4 HL
Organ and bone marrow involvement
