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Leukemia > Lymphoid Lineage > Flashcards

Lymphoid Lineage Flashcards

1
Q

What is CML?

A

CML stands for Chronic Myelogenous Leukemia. It is a form of leukemia that takes a long time to develop (many years) and the cure rate of patients with this leukemia is much higher than patients with AML.

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2
Q

What is CLL?

A

CLL stands for Chronic Lymphocytic Leukemia. It is a cancer of the lymphocytes (a type of white blood cell that helps fight infection). Like CML, CLL progresses slowly and affects mostly older patients. Most of the cancer cells are found in the blood and bone marrow.

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3
Q

Hodgkin Lymphoma

A

This is a cancer of the lymphocytes. Often there will be non painful enlargement of the lymph nodes in the neck, under arm and groin. The primary cells that the Hodgkin Lymphoma affects are the Reed-Sternberg cells. The median age of patients is 39 yrs. This disease is detected at an early age and therefore more treatable.

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4
Q

Non-Hodgkin Lymphoma

A

This is a type of lymphoma where Reed-Sternberg cells are not detected under the microscope. Non-Hodgkin Lymphoma is more common than Hodgkin Lymphoma..
The majority of the patients are older than 55 yrs. This disease is detected at an advanced stage and therefore is harder to treat.

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5
Q

Zevalin

A

This is a mouse monoclonal antibody linked to a radioactive isotope used for treating certain forms of Non-Hodgkin Lymphoma.

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6
Q

Reed Sternberg Cells

A

These are giant cells derived from B lymphocytes and are usually seen in biopsies from patients with Hodgkin Lymphoma.

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7
Q

Lymphocyte

A

Comprises mostly of B and T cells.

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8
Q

What is multiple myeloma?

A

Multiple myeloma is a cancer of the plasma cells. Normal plasma cells produce antibodies to fight germs. In multiple myeloma, these cancer cells overcrowd the normal healthy cells and interfere with antibody production.

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9
Q

What is mantle cell lymphoma?

A

This is a cancer of the B lymphocyte at the outer edge of the lymph node follicle (the mantle zone). The transformed B lymphocyte grows in an uncontrolled manner and causes enlargement of the lymph nodes.

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10
Q

What is the lymphatic system?

A

This a network of tissues and organs that rid the body of unwanted materials, waste and toxins. The primary function of the lymphatic system is to transport lymph, a fluid that comprises of infection fighting white blood cells.

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11
Q

Philadelphia Chromosome

A

This is an abnormal chromosome that is characteristic in white blood cells of CML patients. There is a transclocation where the short end of chromosome 22 is fused with the long end of chromosome 9.

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12
Q

What is SYK?

A

SYK stands for Spleen Tyrosine Kinase and is an important receptor in B cells.

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13
Q

What is BTK?

A

BTK stands for Bruton’s Tyrosine Kinase and is a central mediator of B cell signaling in the developing and functioning of adaptive immunity. Also plays a role in dendritic cells and macrophages.

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14
Q

Ibrutinib

A

This is a FDA approved drug targeting BTK. The mechanism of action is inhibition of CLL cell adhesion and migration.

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15
Q

CD38

A

This is a glycoprotein found in many white blood cells and is a marker for late stages of differentiation. It functions in cell adhesion, signal transduction and calcium signaling.

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16
Q

Lck

A

This is a non- receptor tyrosine kinase from the SRC family found in lymphocytes

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17
Q

Car T cell Therapy

A

These are T cells that have taken out of the patient and engineered so that they can be re-introduced into the patient as a form of immunotherapy

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18
Q

Tumor Lysis Syndrome

A

This is when metabolic abnormalities form when the tumor is lysed during treatment and the tumor’s contents are released into the bloodstream.

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19
Q

Cytokine Release Syndrome

A

This when a large amount of cytokines is released rapidly into the bloodstream as a result of immunotherapy. Some forms of immunotherapy are usage of monoclonal antibodies and Car T Cell therapy.

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20
Q

17p deletion

A

This is a rare genomic aberration found in patients with CLL.

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21
Q

Innate immunity

A

The immune system is programmed to target broad spectrum of pathogens.

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22
Q

Adaptive immunity

A

The immune system is programmed to target a select group of pathogens.

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23
Q

Epstein Barr Virus

A

This is a form of Herpes Virus and is one of the most common viruses in humans. It is spread primarily through saliva.

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24
Q

Car NK Cell Therapy

A

This system is similar to Car T Cell Therapy except there is use of NK cells rather than T cells for targeted therapy. It is more feasible, has reduced levels of cytokine release syndrome and reduced levels of graft vs host disease.

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25
Q

Richter‘s Syndrome

A

This is also known as Richter‘s Transformation which is a transformation of B CLL or hairy cell lymphoma to fast growing diffuse large B cell lymphoma, a form of non-Hodgkin lymphoma which is refractory to treatment and carries a bad prognosis.

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26
Q

Blast Crisis

A

Here large clusters of blasts are seen in the bone marrow and these blasts have moved to tissues and organs. At this stage the CML looks a lot like acute leukemia.

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27
Q

Chronic Phase CML

A

This is when there are less than 10% blasts in the bone marrow and peripheral blood. This may last from several months to several years.

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28
Q

G-Banding (Giemsa Banding)

A

This is a staining procedure used for visualizing the karyotype of condensed chromosomes. It is used to identify genetic diseases.

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29
Q

Hypophosphatemia

A

This is an electrolyte disorder where there is a low level of phosphate in the blood.

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30
Q

Cytogenetic Response

A

The level of Philadelphia chromosomes in leukemic cells.

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31
Q

Major Molecular Response

A

This is when the Bcr-abl gene is less than 1/1000th in the blood of someone who has untreated CML.

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32
Q

Hasford Score

A

This is a 3 tier scoring basis: low, intermediate, high.

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33
Q

Omacetaxine

A

This is protein synthesis inhibitor mostly targeting Bcr-abl. Mostly a last resort drug.

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34
Q

Diuretic

A

Medication that causes an increase in water and salt in the urine.

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35
Q

Myeloablation

A

This is administration of high doses of chemotherapy or radiation therapy to destroy cancer cells. Bone marrow stem cells are also destroyed in the process.

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36
Q

Mononucelosis

A

This is an infection with the Epstein Barr Virus. It is transmitted by saliva.

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37
Q

Adenopathy

A

This is a disease or inflammation of the glandular tissue or lymph nodes.

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38
Q

Pruritus

A

The urge to itch.

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39
Q

Palliative

A

Resolving the pain in a condition without exploring the cause of the pain.

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40
Q

Vinca Alkaloids

A

These are anti-mitotic and anti-microtubule alkaloid drugs isolated from the periwinkle plant.

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41
Q

Procarbazine

A

An alkylating chemotherapy drug that can treat Hodgkin’s disease.

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42
Q

Vincristine

A

A cytotoxic alkylating drug used to treat acute leukemias and other cancers.

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43
Q

Alkylating agents

A

These crosslink (intra and inter) DNA and can also cause the modification of guanine - depurination.

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44
Q

MOPP

A

Nitrogen Mustard Meclorethamine, vincristine, procarbazine and prednisone - Combination chemotherapy for Hodgkin’s Lymphoma.

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45
Q

ABVD

A

Anti-lymphoma drugs used to treat classic Hodgkin’s Lymphoma in the U.S.A.

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46
Q

ZAP70

A

This is an independent negative marker for CLL, usually analyzed by flow cytometry.

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47
Q

CD20

A

This is an marker found in pro B cells, pre B cells and mature B cells.

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48
Q

Idelalisib

A

PI3 Kinase Inhibitor. Causes cell cytotoxicity and inhibits interaction of leukemic cells with the microenvironment.

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49
Q

ABT-199

A

Bcl-2 inhibitor This drug has a binding domain similar to the BH3 family that includes Bcl2. Tumor Lysis Syndrome is a complication associated with this drug.

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50
Q

IGHV

A

This is Immunoglobulin Heavy Chain Variable Region genes. Mutations in these genes in patients with CLL are associated with better responses to some treatments and prolonged survival.

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51
Q

Rituximab

A

This is a drug that is used treat various forms of Non-Hodgkin Lymphoma diseases. Targets the CD20 transmembrane protein present in B cells but not present in plasma cells.

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52
Q

RESONATE Trial

A

This trial compares ibrutinib with monoclonal antibody for CD20 ofatumumab. Ibrutinib showed better OR and OS than ofatumumab.

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53
Q

Fostamatanib

A

This is a SYK inhibitor.

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54
Q

Dasatinib

A

This is a drug that inhibits src kinases and c-abl and in CLL inhibits Lyn.

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55
Q

Binimetinib

A

MEK1/2 inhibitor.

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56
Q

RKIP

A

This is a Raf Kinase Inhibitory Protein.

57
Q

Locostatin

A

RKIP inhibitor.

58
Q

CC-115

A

This is a mTOR inhibitor and DNA Protein Kinase inhibitor.

59
Q

Enzastaurin and Sotrastaurin

A

PKC inhibitors.

60
Q

Bence Jones Proteins

A

High levels of light chain production in Multiple Myeloma.

61
Q

Immunoglobulin

A

5 Heavy Chains (M, A, G, E, D)

2 Light Chains (kappa and lambda)

62
Q

Lenalidomide

A

Also called Revlimid treats the disease, Multiple Myeloma. Lenalidomide is an immunomodulatory drug. Lenalidomide also has anti-inflammatory properties by influencing the TNF alpha pathway.

63
Q

B cell Aplasia

A

This is when CAR-T cell therapy targets B cells with normal CD19 and therefore get a high risk of developing infections. However this can be treated with IVIG (Intravenous Immunoglobulin Replacement Therapy).

64
Q

CONTINUUM STUDY

A

Use of lenalidomide as maintenance therapy with FCR (Fludarabine, Cyclophosphomide and Rituximab).

65
Q

Lucatumumab

A

This drug targets the CD40 antigen and therefore interferes with the CLL cells and T cell interactions. It is a humanized anti-CD40 agonist antibody. However results were disappointing.

66
Q

Ceramide

A

Tumor suppressor lipid

67
Q

Dimethyl Fumarate

A

Downregulates NF-Kappa B activation. Works synergistically with Ibrutinib via mechanism of action that downregulates Wnt signaling.

68
Q

Plerixafor (AMD3100)

A

This is a CXCR4 inhibitor. Acts by preventing CLL cells from homing to the tumor microenvironment.

69
Q

Obinutuzumab

A

This is a humanized CD20 monoclonal antibody.

70
Q

AZD6738

A

This is a drug that is cytotoxic to CLL cells by a mechanism that causes DNA damage.

71
Q

Ruxolitinib

A

JAK inhibitors.

72
Q

Prednisone

A

This is a steroid that treats inflammation.

73
Q

R-HCVAD

A

Rituximab Hyper CVAD treatment

74
Q

Vincristine

A

This is a chemotherapy drug used to treat ALL, AML Hodgkin’s Disease amongst others. It interferes with microtubule formation in the metaphase stage of dividing cells, hence stopping cell division.

75
Q

Blinatumomab

A

This is an anti T cell receptor/ anti-CD19 antibody (FDA approved for R/R ALL). It engages T cells to promote a B cell specific inflammatory and cytolytic response.

76
Q

TOWER Study

A

Use of single agent Blinatumomab for R/R Ph negative ALL.

77
Q

ALCANTRA Study

A

Use of single agent Blinatumomab for R/R Ph positive ALL.

78
Q

Nelarabine

A

This chemical (FDA approved for R/R T cell ALL) accumulates in T cells and incorporates into the DNA, halting DNA synthesis.

79
Q

Vorinostat

A

This is a HDAC inhibitor.

80
Q

Decitabine

A

This is a hypomethylating agent that promotes cell differentiation.

81
Q

Bendamustine

A

Alkylating antineoplastic drug (chemotherapy) for CLL and Non Hodgkin Lymphoma.

82
Q

13q deletion

A

This is the most common chromosomal aberration in CLL (50% of cases) detected by FISH. It carries a good prognosis.

83
Q

11q deletion

A

This is when the long arm of chromosome 11 is missing or deleted.

84
Q

ZAP70

A

Zeta Chain Associated Protein Kinase. This protein is part of signaling pathway that turns on T cells.

85
Q

Immunoglobulin Heavy Chain Mutation Status

A

This is a clinical test to assess outcomes of patients with CLL treated with chemoimmunotherapy.

86
Q

Foxp3

A

This is Forkhead box P3 and is important for the development of Treg suppressor phenotype.

87
Q

Garcinol

A

This is a p300 inhibitor which induces apoptosis.

88
Q

GCN5

A

This controls the PI3 Kinase pathway by regulating the transcription of Btk and Syk in B cells.

89
Q

Tip60

A

This is the catalytic subunit of the NuA4 complex that is involved in the transcriptional activation of genes. The target is H4 and H2A histones. Tip60 can bind to c-Myb and negatively regulate its function thereby inhibiting leukemogenesis.

90
Q

MOZ-TIF2

A

This contains the CBP Interaction domain of TIF2 and the HAT domains of MOZ and TIF2. The MOZ-TIF2/CBP complex is essential for transformation by inhibition of transcription of tumor suppressors such as p53. STAT5 is required for MOZ-TIF2 mediated leukemogenesis.

91
Q

Beleodaq

A

This is a FDA approved drug for patients with peripheral T cell lymphomas (PTCL). PTCL accounts for 15% of all non-Hodgkin lymphomas. Beleodaq inhibits HDAC.

92
Q

CTCL

A

This is Cutaneous T Cell Lymphoma that is a form of Non-Hodgkin Lymphoma of the T cells (occurs as skin lesions).

93
Q

Types of HDAC inhibitors

A

1) Vorinostat
2) Depsipeptide
3) MS-275

94
Q

Depsipeptide

A

This is a HDAC inhibitor in the class cyclic peptide.

95
Q

MS-275

A

This is a HDAC inhibitor in the class benzamide.

96
Q

Gemcitabine

A

This is an anti-cancer chemotherapy drug.

97
Q

Tubacin

A

This is a HDAC inhibitor against HDAC6 isoform.

98
Q

H2AX

A

This is a histone involved in the DDR pathway and is inhibited by JQ1 (BRD4 inhibitor).

99
Q

Panobinostat

A

This is a HDAC inhibitor.

100
Q

Cox proportional hazards model

A

This is a regression model that is used as a statistical tool in medical research. It compares the survival time of a patient population with one or more predictor variables.

101
Q

Tositumomab

A

This a type II monoclonal anti CD20 antibody used to treat CLL.

102
Q

AUTO3

A

This is a form of dual CAR-T cell therapy for both CD19 and CD22 antigens.

103
Q

Autologous

A

This means from the same tissues or cells.

104
Q

Follicular Lymphoma

A

This is a slow growing or indolent form of Non Hodgkin Lymphoma.

105
Q

Brentuximab Vedotin

A

This is a chimeric CD30 antibody conjugated to the microtubule polymerization inhibitor MMAE. This drug was approved for Class III and Class IV Hodgkin Lymphoma.

106
Q

Hyaluronic Acid

A

This is a clear gooey liquid produced in the body found in eyes, skin and connective tissue. Its main function is to retain water and keep tissues well lubricated and moist.

107
Q

CD44

A

This is an adhesion molecule found in macrophages, lymphocytes, hematopoietic stem cells and leukemic cells. It binds to hyaluronic acid in the bone marrow microenvironment and is involved in leukemic stem cell adhesion and migration.

108
Q

Ublituximab

A

This is a glycoengineered monoclonal antibody that targets an unique epitope of CD20 expressing B cells.

109
Q

Blinatumomab

A

This is a bi specific antibody targeting CD3 and B lymphocyte antigen CD19.

110
Q

HELIOS Trial

A

This is a trial where the drug Ibrutinib is added to a combination of Bendamustine and Rituximab in CLL patients.

111
Q

OKT3

A

This is a CD3 targeting antibody.

112
Q

SIGLEC 3

A

This is bi specific antibody targeting CD3 and CD33.

113
Q

Granzyme

A

These are serine proteases that are released by cytoplasmic granules in cytotoxic T cells and Natural Killer cells.

114
Q

Perforin

A

These are proteins responsible for pore formation in the cell membranes of target cells.

115
Q

RG6026

A

This is a trivalent bi specific antibody with one CD3 and two TAA binding units.

116
Q

solid tumor

A

This is a mass of abnormal tissue that doesn’t contain cysts or liquid areas.

117
Q

Acalabrutinib

A

This is a drug for Non-Hodgkin Lymphoma, mantle cell lymphoma, cll, sll.

118
Q

4G8SDIEM

A

This is Fc optimized monoclonal antibody against Flt3.

119
Q

Hairy Cell Leukemia

A

This is an uncommon hematologic malignancy where there is an accumulation of abnormal B lymphocytes. It is a subtype of CLL. The lymph nodes in this type of leukemia do not enlarge.

120
Q

Cladribine

A

This is a drug for treatment of Hairy Cell Leukemia. The 5 year event free survival for patients on this drug is 90%.

121
Q

Hazard Ratio

A

This is the ratio of the hazard rates of two different conditional variables.

122
Q

Cyclosporine

A

This is a immunomodulatory drug that prevents production of cytokines from T cells, namely preventing the transcription of IL2.

123
Q

Duvelisib (COPIKTRA)

A

This is a drug that targets PI3 Kinase delta and PI3 Kinase gamma and has effects on the tumor micro-environment as well as CLL cells.

124
Q

Chlorambucil

A

This is an alkylating agent that induces cell apoptosis by causing an accumulation of p53 protein and activating Bax, an apoptosis promoter.

125
Q

R-CHOP

A

This is a chemotherapy cocktail for Non-Hodgkin Lymphoma and Mantle Cell Lymphoma. The acronym stands for Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisone.

126
Q

R-CVP

A

This is a chemotherapy drug cocktail for indolent forms of Non-Hodgkin Lymphoma. The acronym stands for Rituximab, Cyclophosphamide, Vincristine and Prednisone.

127
Q

BCMA Car-T Cell Therapy

A

This is B Cell Maturation Antigen Car-T Cell Therapy targeted to treat multiple myeloma.

128
Q

TIGIT antibody

A

This antibody is involved in immune checkpoint inhibition by augmenting anti-tumor effector CD8+ T cells and anti-tumor NK cells and suppresses activity of T regulatory cells.

129
Q

Pomalidomide

A

This is an anti-angiogenic substance and also an immunomodulator. It is used to treat multiple myeloma.

130
Q

Atrial fibrillation

A

This is an irregular heart beat (arrhythmia).

131
Q

Single Arm Studies

A

These are studies where a sample of individuals with the targeted medical condition is given experimental therapy and then followed over time to observe their response.

132
Q

Tertiary Care Centers

A

These are places where highly specialized medical care is given in state of art facilities. The procedures are advanced and complex.

133
Q

Event Free Survival

A

This is the length of time a patient goes through during cancer treatment when he/she is free of complications the treatment was intended to prevent or delay.

134
Q

BiTE

A

This acronym stands for Bi-specific T cell Engager. It is a recombinant fusion antibody using two single chain variable fragments.

135
Q

Fab of antibody

A

This is the part of the antibody that mediates antigen binding

136
Q

Fc of antibody

A

This is called Fragment Crystallizable Region and is part of the antibody that binds to effector immune cells.

137
Q

Diabody

A

This is a dimer of two antibody fragments that are covalently linked to one another.

138
Q

DART

A

These are Dual Affinity Retargeting Antibodies. These are diabodies that have heavy and light chain variable domains of two antigen binding specifities linked to two independent polypeptide chains

Leukemia (5 decks)

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