Leukemia And Lymphoma

Question 1

N. What’s the most common malignant disease in children?

Answer 1

Acute lymphocytic leukemia

Question 2

N. BCR-ABL gene fusion is mostly involved in……..leukemia

Answer 2

Chronic myeloid leukemia

Question 3

N. Name the cell type that is predominantly present in acute leukemia?

Answer 3

Early hemopoietic progenitor cells

Question 4

N. What are the steps in diagnosis acute lymphocytic leukemia?

Answer 4

Blood film, imunnophemotyping, genetic analysis

Question 5

N. In acute lymphocytic leukemia, if the chromosomes abnormalities was ( less than 46 chromosomes = hypodiploidy, or there’s BCR-ABL ( Philadelphia t 9:22) . We know the prognosis is…..

Answer 5

Poor

Question 6

N. Treatment of acute lymphocytic leukemia consists of 3 steps. Name them?

Answer 6

Remission induction: initial chemotherapy that kills most of the tumors cells /
Consolidation : blocks of intensive chemotherapy to kill the rest of cancer cells /
Maintenance : less intensive treatment is given for 1-2 years taken as tablet or injection

Question 7

N. What are the most important drugs used for treatment of acute lymphocytic leukemia? 4

Answer 7

Steroids (to kill lymphoblasts) / vincristine (affect microtubules) / daunorobicine ( chemotherapy) / Asparaginase (⬇️ aminoacids

Question 8

N. Other drugs used in acute lymphocytic leukemia are….? 3

Answer 8

Cytosine arabinoside ( analogue) / CNS chemotherapy: by high dose IV or directly by intrathecal chemotherapy / bone marrow transplantation

Question 9

N. acute myeloid leukemia affects all ages, it may develop from pre malignant condition & genetic analysis is very important. True or false.

Answer 9

True

Question 10

N. What’s the most common concern/complication of acute promyelocytic leukemia?

Answer 10

Disseminated intravascular coagulation ( DIC )

Question 11

N. Acute promyelocytic leukemia is caused by t …. : ….. translocation

Answer 11

t 15:17 translocation

Question 12

N. What’s the name of the drug used in acute promyelocytic leukemia in conjunction with chemotherapy?

Answer 12

All- trans retinoic acid ( ATRA )

Question 13

N. Cure rates for A.L.L in children is 85% while AML is only 50% in children and <8% in adults >65 years. True or false.

Answer 13

True

Question 14

N. …….is common site for relapse in acute lymphocytic leukemia.

Answer 14

CNS

Question 15

N. Chronic lymphoid leukemia develops from accumulation of a clone of …..cells in the bone marrow, blood, lymph nodes which is used for diagnosis

Answer 15

B cells ( which have phenotype CD5+ CD23+ )

Question 16

N. Most of chronic lymphoid leukemia cases are discovered in routine check up and therefore the treatment in mild cases is watch and wait. True or false?

Answer 16

True

Question 17

N. What’s the standard treatment in chronic lymphoid leukemia after the watch and wait phase?

Answer 17

Antibody against B cells ( CD20 ) with chemotherapy ( usually 6 courses are given )

Question 18

N. What’s the MOA for the new tablet used to treat chronic lymphoid leukemia?

Answer 18

Blocks B cell receptors signaling through inhibition of BTK or PI3K delta

Question 19

N. In treating chronic myeloid leukemia the ptn is giving a tablet that acts only on CML tumor cells by inhibiting the bcr-abl kinase protein. What is the tablet called ?

Answer 19

Imatinib

Question 20

N. In ptn with CML resistant to imatinib tablet, what’s the new other alternative drug?

Answer 20

Tyrosin kinase inhibitors

Question 21

N. Ebstian bar virus ( EBV is ) ass with ………… lymphoma

Answer 21

Hodgkin lymphoma

Question 22

N. What’s the characteristic feature that is found in biopsy for Hodgkin lymphoma ptn?

Answer 22

Reed-Sternberg ( RS ) cells ( they have bilobed nuclei and derived from B cell and express CD15, CD30 )

Question 23

N. What’s the standard chemotherapy regimen used in Hodgkin lymphoma?

Answer 23

ABVD ( adriamycin, bleomycin, vinblastine, dacarbazine )

Question 24

N. In diagnosis of lymphoma we use biopsy with PET scan that involves injection of ……..glucose

Answer 24

Flurodeoxyglucose (FDA )

Question 25

N. Hodgkin lymphoma has a good outcome, true or false?

Answer 25

True

Question 26

N. What are the treatments used in relapse Hodgkin lymphoma? 4

Answer 26

Different chemotherapy, autologous or allogenic stem cell transplant , antibodies to block PD-L1 , antibodies against CD30

Question 27

N. 85% of non-Hodgkin lymphoma are derived from…..cells and the rest from…..cells.

Answer 27

B cells, T Cells

Question 28

N. Non-Hodgkin lymphoma is increasing in incidence and might be triggered by ……

Answer 28

Infection

Question 29

N. In non Hodgkin lymphoma when we say the disease has high grade it means that it’s ……. But curable. While when we say low grade it means it’s slow but……..

Answer 29

High grade = aggressive but curable / low grade = slow but hard to cure

Question 30

N. What are the steps in diagnosis of non-Hodgkin lymphoma?

Answer 30

Biopsy/ immunohistochemistry / cytogenetic & mutation analysis ( t 14:18 = follicular lymphoma / while MYD88 = lymphoblastic lymphoma) / CT, PET scans

Question 31

N. The most important subtype of high grade nHL is ……. Large B cell

Answer 31

Diffuse large B cell lymphoma ( DLBCL )

Question 32

N. The treatment for high grade nHL is ……….with chemotherapy

Answer 32

Antibody against CD20 ( eg,. R-chop )

Question 33

N. In high grade nHL the survival rate is……%

Answer 33

65%

Question 34

N. Follicular ( low grade ) lymphoma Carrie’s t … : …. Translocation leading to over expression of bcl-2 and its usually more common in ….people

Answer 34

t 14:18 , old people

Question 35

N. Treatment of Follicular lymphoma is complicated therefore it’s only given to symptomatic ptn. The chemotherapy used is ………?

Answer 35

R-bendamustinevor or R-CVP

Question 36

What are the types of nHL?

Answer 36

Low grade = Follicular, high grade = diffuse large B cell lymphoma, mantle cell lymphoma, lymphoplasmacytic lymphoma, Burkitt lymphoma, T-cell lymphoma

Question 37

N. BTK inhibitors play and important role of treating ………..cell lymphoma and ………lymphocytic leukemia

Answer 37

Mantle cell lymphoma and chronic lymphocytic leukemia

Question 38

N. Name the subtype of nHL that affects lymph nodes and bone marrow ?

Answer 38

Lymphoplasmacytic lymphoma

Question 39

N. The MYD88 gene is mutated in most cases of ………..lymphoma

Answer 39

Lymphoplasmacytic lymphoma

Question 40

N. The characteristic feature in lymphoplasmacytic lymphoma is the production of Ig…. ParaProtein

Answer 40

IgM protein ( it causes hyperviscosity )

Question 41

N. What’s the other name of lymphoplasmacytic lymphoma?

Answer 41

Waldenstorm’s macroglobulinemia

Question 42

N. Burkitt lymphoma is an aggressive lymphoma which is ass. With malarial infection and ……virus infection and HIV

Answer 42

EBV

Question 43

N. Burkitt lymphoma is common among……… and needs urgent aggressive chemotherapy

Answer 43

African children