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Oncology Boards > LSA - General > Flashcards

LSA - General Flashcards

1
Q

What chromosomal changes have been documented in canine LSA?

A

gains of canine chromosomes 13 and 31, loss of 14

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2
Q

Tisomy of what chromosome increased duration of first remission and OST in dogs with LSA?

A

chromosome 13

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3
Q

____ virus is a _____ type of virus that has been linked to some forms of LSA in humans but has not been linked to canine LSA

A

Epstein-Barr, gammaherpesvirus

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4
Q

Helicobacter infection in Beagles showed gastric lymphoid follicle formation that is considered a precursor of what lymphoma in humans?

A

mucosa-associated lymphoid tissue (MALT) LSA

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5
Q

What herbicide has been shown to increase the risk of LSA in dogs?

A

2,4-dichlorophenoxyacetic acid (2,4-D)

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6
Q

What % of cats undergoing renal transplant developed cancer while on cyclosporine immunosuppressive therapy?

A

36%

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7
Q

In what breed has a syndrome of immunoproliferative instestinal disease characterized by LP-IBD that can develop into GI LSA been recognized?

A

Basenjis

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8
Q

In what % of dogs is hypercalcemia found?

A

10-40%

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9
Q

Epitheliotropic cutaneous LSA typically originates from ____ cells in dogs vs. ____ cells in humans

A

Dogs: CD8+ T cells

Humans: CD4+ T cells

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10
Q

What is it called when a patient with cutaneous LSA develop peripherally circulating large malignant t cells?

A

Sezary syndrome

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11
Q

What is intravascular LSA?

A

akak angiotropic or angioendotheliomatosis

proliferations of neoplastic lymphs w/in lumen and wall of blood vessels in absence of primary extravascular mass or leukemia

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12
Q

What anatomic form of canine LSA has intravascular LSA been most commonly associated with

A

CNS or PNS LSA

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13
Q

What criteria does the REAL/WHO system for LSA incorporate

A

anatomic, morphologic (cyto and histo), and immunophenotype

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14
Q

What does the National Cancer Institue Working Formulation (WF) use to categorize LSA?

A

Pattern (diffuse or follicular)

cell type

does NOT include immunophenotype

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15
Q

What does the updated Kiel classifcation used to classify LSA?

A

architectural pattern

morphology (centroblastic, centrocytic or immunoblastic)

immunophenotype

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16
Q

Diffuse pulmonary infiltration on radiographs is present in what % of dogs with multicentric LSA?

A

27-34%

Actual incidence may be higher based on BAL data

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17
Q

What are the anatomic site categories used for WHO staging of LSA in domestic animals?

A

A. Generalized

B. Alimentary

C. Thymic

D. Skin

E. Leukemia

F. Others

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18
Q

What are the three clinical stages of epitheliotropic T-cell LSA?

A
  1. scaling, alopecia and pruritus
  2. progression to erythematous, thickened, ulcerated and exudative lesions
  3. progression to proliferative plaques and nodules with progressive ulceration
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19
Q

What was the ORR and MST for horses treated with chemo for LSA? (Luethy JVIM 2018)

A

ORR 93.3%, CR 33%, PR 60%, SD 7%

MST 8mo

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20
Q

What is the most common subtype of lymphoma in horses?

A

Multicentric

T cell rich Large B cell LSA

(peripheral T cell LSA and DLBCL also frequent)

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21
Q

Most canine LSA that involves the CNS is ____ (primary vs. secondary) and is ______ (T or B cell). LSA of the PNS is usually _____ (T or B cell)

A

CNS usually secondary and B cell

PNS usually T cell

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22
Q

What is the MST of dogs with presumed solitary ocular LSA (PSOL) treated with enuc?

A

if no systemic involvement 769d

if systemic involvement 103d

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23
Q

What is the most common paraneoplastic syndrome associated with LSA?

A

Anemia

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24
Q

Hypercalcemia associated with LSA is usually due to ____ but can be associated with what other factors?

A

PTHrp

Also production of IL-1, TNF-alpha, TGF-beta and vitamin D analogs

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25
Q

Monoclonal gammopathies occur in ~_____% of dogs with LSA

A

6%

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26
Q

What are the usual T cell flow markers

A

CD3 (pan T) CD4 (helper T) CD8 (cytotoxic T)

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27
Q

What are the usual flow B cell markers? Which one can also be expressed by TZL?

A

CD79a, CD20 and CD21

CD21 can also be expressed by TZL

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28
Q

T cell precursor LSA has what immunophenotype

A

CD45+, CD34+/-, CD5+/-, CD3+/-, CD4+/-, CD8-

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29
Q

B cell precursor lymphoma has what immunophenotype?

A

CD45+, CD18+, CD34+/-, CD79a+, CD21+/-, CD20+/-

30
Q

Based on withrow, standard CHOP-based chemo induces remission in ____% of dogs with overall MSTs of _____ and ____% alive at 2years after initiation of chemo

A

remission in 80-95% of dogs

MST 10-12mo

20-25% of dogs alive at 2 yrs

31
Q

Based on withrow, the CR rate fod gos with LSA treated with single-agent dox is ____% with an MST of ______

A

50-75%, MST 6-8mo

32
Q

What is the most important outcome measure and preferred temporal outcome criterion for assessing LSA protocols?

A

PFS

33
Q

What are the canine mAb drugs designed to target B-cell or T-cell LSA? Why aren’t these commercially available

A

B cell: blontuvetmab/Blontress (meant for CD20)

T cell: tamtuvetmab/Tactress (meant for CD52)

Specificity inadequate to effect clinical efficacy

34
Q

What are the most consistently identified prognostic factors for peripheral nodal LSA in dogs?

A

immunophenotype

WHO substage (a vs. b)

indolent classification

35
Q

Dogs with low expression of class II MHC and what other Ag have been shown to have shorter remissions and survival times

A

B5 antigen

36
Q

What are the three primary subtypes of CLL in dogs?

A
  1. T-CLL (most common), usually CD3+/CD8+ granular lymphs
  2. B-CLL (next most common) CD21+
  3. Atypical CLL
37
Q

What is the most distinguishing cyto feature of large lymphs in ALL

A

Large lymphs have a nuclear chromatin patter that is typically less condensed that chromatin in small lymphs but more condense than myeloblasts

38
Q

What % of dogs with CLL had monoclonal gammopathies and what type were they usually?

A

68%, usually IgM or IgA

39
Q

What is the term for CLL that evolves into an acute phase that is rapidly progressive and characterized by large lymphs?

A

Richter’s syndrome

happens in 2% of T-CLLs and 10% of B cell CLL

40
Q

Siamese/oriental breeds are more likely to be what age and develop what form of LSA?

A

Younger (median 2yrs)

Mediastinal that is not related to FeLV

41
Q

FIV associated LSA is more likely to be ______ phenotype. FeLV associated LSA is more likely to be ________ phenotype

A

FIV: B cell

FeLV: T cell

42
Q

What environmental factor has been associated with an increased risk of LSA in cats?

A

environmental tobacco smoke (ETS) - risk increases with duration of exposure

43
Q

THe majority of LGAL (low-grade alimentary LSA) in cats are what phenotype and are thought to arise from what?

A

T-cell

MALT

44
Q

Most T-cell GI LSA in cats are mucosal and equivalent to what WHO type?

A

WHO enteropathy-associated T-Cell LSA (WHO EATCL) type II

45
Q

The majority of feline intermediate or high grade alimentary LSAs are ____ phenotype and equivalent to what WHO classification?

A

B cell

WHO EATCL type I (even though that stands for enteropathy-associated T cell LSA…)

46
Q

Large granular LSA stains for what with IHC and includes what cells? What other marker is commonly expressed?

A

IHC: granzyme B, also 60% expressed CD103 (integrin alpha E)

cytotoxic t cells (usually CD3+/CD8+/CD21-) but also includes NK cells

47
Q

According to withrow, when treated with combination chemotherapy, cats with intermediate to high grade alimentary LSA have ____% response rates with ~_______ CR. Cats with CR have MSTs of _____

A

50-65% response rate

1/3 CR, MST 7-10mo

48
Q

Cats with Hodgkin’s like LSA have what immunophenotype

A

T-cell-rich-B-cell LSA

49
Q

PARR in cats is approximately ____% sensitive for the diagnosis of LSA

A

80%

50
Q

According to withrow, ~____ of cats with renal LSA will benefit from COP or CHOP based protocols with MSTS reported to be ______

A

2/3’s of cats benefit

MSTs 4-7mo

51
Q

~____% of cats with CNS LSA are FeLV antigenemic

A

50%

52
Q

Most cats with ocular LSA are presented with what?

A

Uveitis or iridial masses + signs related to systemic involvement of LSA

53
Q

~_____% of cats with ALL are FeLV positive and have ______ immunophenotype

A

60-80%, T cell

54
Q

Serum thymidine kinase 1 is higher or lower in dogs with lymphoma compared to control dogs (Boye, JVIM 2019)

A

Higher (>20Du/L) Dogs that achieved CR sTK1 similar to controls; PR higher than controls

55
Q

A ___ increase in serum thymidine kinase 1 predicted relapse at next recheck in dogs with LSA; sensitivity and specificity? (Boye, JVIM 2019)

A

5-fold increase; sensitivity 50%, specificity 94%

56
Q

What forms of LSA less likely to have high serum thymidine kinase 1 at baseline

A

T cell Small or intermediate LSA

57
Q

Rate of response for equine LSA (Luethy JVIM 2019)

A

CR 33.3% (5/15) PR 60% SD 6% ORR = 93.3%

58
Q

AEs related to chemotherapy in horses treated for LSA (Luethy JVIM 2019)

A

Mostly mild, related to doxorubicin most commonly, 1 grade 5 hypersensitivity

59
Q

Most common forms of LSA in horses (Luethy JVIM 2019)

A

T cell rich diffuse B cell LSA

60
Q

MST for horses with LSA (Luethy JVIM 2019)

A

MST 8mo, best for epititheliotropic (34mo)

61
Q

Did duodenal perfusion measured by contrast-enhanced ultrasound show differences in dogs with intestinal LSA compared to chronic inflammatory enteropathy or controls

A

No - differences between symptomatic CIE dogs and controls/asymptomatic CIE dogs, but no differences for LSA dogs

62
Q

Factors associated with decreased odds of developing T-zone LSA (Labadie JVIM 2019)

A

Omega-3 supplementation Hypothyroidism

63
Q

Factors associated with increased odds of developing T-zone LSA (Labadie JVIM 2019)

A

Historic or concurrent mange

64
Q

Shared associations between t-zone lymphoma and T-zone-like cells of undetermined significance (TZUS)

A

UTI/calculi Eye disease

65
Q

Progression free survival time and MST for dogs treated with mito instead of doxo (CMOP) compared to CHOP dogs? (JAVMA 2019, Marquardt)

A

CMOP (n=44) - 100% CR or PR (81.8%/18.2%) - PFS 165, MST 234 CHOP (n = 51) - 97.4% CR or PR (92.1%/5.3%) - PFS 208, MST 348d (not stat sig compared to CMOP)

66
Q

Prevalence of anemia in dogs with LSA vs. IBD? (Parachini-Winter JAVMA 2019)

A

LSA 53% IBD 22%

67
Q

Individual RBC anomaly more common in LSA vs. IBD? (Parachini-Winter JAVMA 2019)

A

Eccentrocytes

68
Q

Incidence of large-cell LSA dx following previous treatment for small-cell GI LSA in cats (Wright, JFMS 2019)

A

9.9% (12/121)

69
Q

Mean event-free survival time and MST from time of diagnosis of large cell LSA for cats previously treated for small cell GI-LSA? Wright JFMS 2019

A

Mean event-free survival = 55d

MST =24.5d

70
Q

Hematologic changes significantly decreased in cats that developed large cell LSA after treatment of small cell GI-LSA? Wright JFMS 2019

A

HCT, albumin and total protein (compared to values at dx of small cell GI LSA)

Oncology Boards (26 decks)

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