Lymphoid malignancies Flashcards
in what age group is acute lymphoblastic leukaemia most common in?
children < 6 yrs
what cell type is majority of acute lymphoblastic leukaemia?
75-90% B-cell
what is the presentation of acute lymphoblastic leukaemia?
2-3 weeks of bone marrow failure - anaemia, infections, mucosal bleeding (thrombocytopenia)
or bone / joint pain
what is the average maintenance of treatment for acute lymphoblastic leukaemia?
18 months
what cytogenetics are an important indicator of poor prognosis in acute lymphoblastic leukaemia?
t(9;22)
t(4;11)
what is the remission rate and 5 yr survival for adults with ALL?
90% remission rate
5 year survival 30-35%
what is the 5yr survival rate for children with ALL?
90% 5 yr survival
what is the treatment for acute lymphoblastic leukaemia?
multi-agent intensive chemotherapy +/- allogenic stem cell transplant
what lymphocyte count is required for a diagnosis of chronic lymphocytic leukaemia ?
lymphocyte count > 5
what is the presentation of chronic lymphocytic leukaemia?
often asymptomatic at presentation
- bone marrow failure
- lymphadnopathy
- splenomegaly
- fever and night sweats
- haemolytic anaemia
less common;
- hepatomegaly
- infections
- weight loss
what is immune paresis and in what lymphoid malignancy is it found in?
loss of normal immunoglobulin production
chronic lymphocytic leukaemia
what staging criteria is used for chronic lymphocytic leukaemia?
Binet
what are the 3 stages in the Binet staging of chronic lymphocytic leukaemia?
A - < 3 lymph node areas
B - 3 or more lymph node areas
C - stage B + anaemia or thrombocytopenia
what are the treatment options for chronic lymphocytic leukaemia?
often nothing - watch and wait
cytotoxic chemotherapy monoclonal antibodies novel agents; - bruton tyrosine kinase inhibitor - P13K inhibitor - BCL-2 inhibitor
production of what monoclonal antibody is a poor prognostic marker for chronic lymphocytic anaemia?
CD 38+
what is the presentation of lymphoma?
lymphadenopathy
hepatosplenomegaly
extra nodal disease
B symptoms - sweats, weight loss, fever
is diffuse B-cell lymphoma high or low grade?
high grade
is follicular lymphoma low or high grade?
low grade
what is the treatment for diffuse large B-cell lymphoma?
anti-CD20 monoclonal antibody + chemotherapy
what is the treatment for follicular lymphoma?
anti-CD20 monoclonal antibody and chemotherapy
what are the 2 most common types of non-hodgkins lymphoma ?
follicular
diffuse large B-cell
in what gender is non-hodgkins most common ?
male : female
1.9:1
what is associated with development of hodgkins lymphoma?
EBV (later life)
glandular fever
familial
geographical clustering
what are the poor prognostic markers for CLL?
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
what is the age prevalence in hodgkins lymphoma?
1st peak 15-35yrs
2nd peak in later life (EBV associated)
what monoclonal antibody does all Hodgkins lymphoma express?
Anti- CD 30
what staging system is used for lymphoid malignancies?
Ann Arbor
expression of CD-5 most commonly associated with what lymphoid cancers?
CLL
mantel cell lymphoma
what CD markers are indicative of CLL?
CD- 5
CD - 23
what markers are indicative of a T-cell lymphoproliferative disease?
t-DT
CD - 34
what CD markers do B cells express?
CD 19, CD 20, CD 22
