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Haematology and Immunology > Lymphoid malignancies > Flashcards

Lymphoid malignancies Flashcards

1
Q

in what age group is acute lymphoblastic leukaemia most common in?

A

children < 6 yrs

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2
Q

what cell type is majority of acute lymphoblastic leukaemia?

A

75-90% B-cell

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3
Q

what is the presentation of acute lymphoblastic leukaemia?

A

2-3 weeks of bone marrow failure - anaemia, infections, mucosal bleeding (thrombocytopenia)
or bone / joint pain

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4
Q

what is the average maintenance of treatment for acute lymphoblastic leukaemia?

A

18 months

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5
Q

what cytogenetics are an important indicator of poor prognosis in acute lymphoblastic leukaemia?

A

t(9;22)

t(4;11)

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6
Q

what is the remission rate and 5 yr survival for adults with ALL?

A

90% remission rate

5 year survival 30-35%

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7
Q

what is the 5yr survival rate for children with ALL?

A

90% 5 yr survival

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8
Q

what is the treatment for acute lymphoblastic leukaemia?

A

multi-agent intensive chemotherapy +/- allogenic stem cell transplant

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9
Q

what lymphocyte count is required for a diagnosis of chronic lymphocytic leukaemia ?

A

lymphocyte count > 5

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10
Q

what is the presentation of chronic lymphocytic leukaemia?

A

often asymptomatic at presentation

  • bone marrow failure
  • lymphadnopathy
  • splenomegaly
  • fever and night sweats
  • haemolytic anaemia

less common;

  • hepatomegaly
  • infections
  • weight loss
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11
Q

what is immune paresis and in what lymphoid malignancy is it found in?

A

loss of normal immunoglobulin production

chronic lymphocytic leukaemia

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12
Q

what staging criteria is used for chronic lymphocytic leukaemia?

A

Binet

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13
Q

what are the 3 stages in the Binet staging of chronic lymphocytic leukaemia?

A

A - < 3 lymph node areas
B - 3 or more lymph node areas
C - stage B + anaemia or thrombocytopenia

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14
Q

what are the treatment options for chronic lymphocytic leukaemia?

A

often nothing - watch and wait

cytotoxic chemotherapy 
monoclonal antibodies 
novel agents;
- bruton tyrosine kinase inhibitor
- P13K inhibitor 
- BCL-2 inhibitor
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15
Q

production of what monoclonal antibody is a poor prognostic marker for chronic lymphocytic anaemia?

A

CD 38+

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16
Q

what is the presentation of lymphoma?

A

lymphadenopathy
hepatosplenomegaly
extra nodal disease
B symptoms - sweats, weight loss, fever

17
Q

is diffuse B-cell lymphoma high or low grade?

A

high grade

18
Q

is follicular lymphoma low or high grade?

A

low grade

19
Q

what is the treatment for diffuse large B-cell lymphoma?

A

anti-CD20 monoclonal antibody + chemotherapy

20
Q

what is the treatment for follicular lymphoma?

A

anti-CD20 monoclonal antibody and chemotherapy

21
Q

what are the 2 most common types of non-hodgkins lymphoma ?

A

follicular

diffuse large B-cell

22
Q

in what gender is non-hodgkins most common ?

A

male : female

1.9:1

23
Q

what is associated with development of hodgkins lymphoma?

A

EBV (later life)
glandular fever
familial
geographical clustering

24
Q

what are the poor prognostic markers for CLL?

A 
Binet stage B or C 
atypical lymphocyte morphology 
rapid lymphocyte doubling time (<12 months)
CD 38 expression
loss/mutation p53; del 11q23
unmated IgVH gene status
25
Q

what is the age prevalence in hodgkins lymphoma?

A

1st peak 15-35yrs

2nd peak in later life (EBV associated)

26
Q

what monoclonal antibody does all Hodgkins lymphoma express?

A

Anti- CD 30

27
Q

what staging system is used for lymphoid malignancies?

A

Ann Arbor

28
Q

expression of CD-5 most commonly associated with what lymphoid cancers?

A

CLL

mantel cell lymphoma

29
Q

what CD markers are indicative of CLL?

A

CD- 5

CD - 23

30
Q

what markers are indicative of a T-cell lymphoproliferative disease?

A

t-DT

CD - 34

31
Q

what CD markers do B cells express?

A

CD 19, CD 20, CD 22

Haematology and Immunology (15 decks)

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