Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Haematology and immunology > Lymphoid malignancies > Flashcards

Lymphoid malignancies Flashcards

1
Q

How can lymphomas present?

A

Enlarged lymph nodes (Lymphadenopathy)
Extranodal involvement
Bone marrow involvement
Systemic (B) symptoms - Weight loss >10% in 6 months, fever, night sweats, pruritis, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is lymphoma diagnosed?

A

Biopsy to tell us the type

Clinical examination and imaging for staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malignancy in which cells causes acute lymphoblastic leukaemia?

A

Lymphoid progenitor/immature lymhpoid cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Malignancy in which cells cause chronic lymhpoid leukaemia and lymphomas?

A

Mature lymphoid cells - B cells and T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is non-hodgkin lymphoma?

A

Any lymphoma that isn’t Hodgkin lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is ALL?

A

Cancerous disorder of lymphoid progenitor cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the normal pathway of lymphoid progenitors?

A

Immature, rapidly proliferating cells differentiating into lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens in leukaemia?

A

No differentiation, instead, rapid, uncontrolled growth and accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where does ALL usually present?

A

Usually in bone marrow but can be anywhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does ALL present?

A

2-3 week history of bone marrow failure or bone/joint pain

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common form of ALL?

A

B-cell lineage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What blood counts would you expect from ALL?

A

Very low haemoglobin
Extraordinarily high white cell count
Low platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are characteristics of malignant cells in ALL?

A

Large cells
Express CD19 marker -all B-cells have this
Express CD34 and TDT - markers of very early, immature cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is standard treatment for ALL?

A

Induction chemotherapy to obtain remission
Consolidation therapy
CNS directed treatment
Maintenance treatment for 18 months
Stem cell transplantation if high risk - adult patient
Bi-specific T-cell engagers (BiTe molecules) - blinatumumab
Chimeric antigen receptor T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Chimeric antigen receptor T-cells treatment?

A

Patient/healthy 3rd party T-cells harvested
Transfected to express a specific T-cell receptor expressed on leukaemia cells (CD19)
Expanded in vitro
Re-infused into patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are key side effects of CAR T-cell treatment?

A

Cytokine release syndrome - fever, hypotension, dyspnoea

Neurotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are ALL poor risk factors?

A

Increasing age
Increased white cells
Cytogenetics/molecular genetics
Slow/poor response to treatment

18
Q

What is Chronic lympoid leukaemia?

A

Mature lymphoid cells, grows slowly, requires a lymphocyte count >5

19
Q

How does CLL typically present?

A 
Often assymptomatic at presentation
Bone marrow failure - anaemic/thrombocytopenic
Lymphadenopathy
Splenomegaly
Fever and sweats
Immune paresis
Haemolytic anaemia
20
Q

What is immune paresis?

A

Loss of normal immunoglobulin production

21
Q

What staging system is used for CLL?

A

Binet system

22
Q

What is stage A CLL?

A

<3 lymph node areas

23
Q

What is stage B CLL?

A

3 or more lymph node areas

24
Q

What is stage C CLL?

A

Stage B + anaemia or thrombocytopenia

25
Q

What are indications for treatment of CLL?

A 
Progressive bone marrow failure
Massive lymphadenopathy
Progressive splenomegaly
Lymphocyte doubling time <6 months or >50% increase over 2 months
Systemic symptoms
Autoimmune cytopenias
26
Q

How is CLL treated?

A

Often nothing - watch and wait
Cytotoxic chemotherapy
Monoclonal antibodies
Novel agents

27
Q

What are examples of cytotoxic chemotherapy drugs used in CLL?

A

Fludarabine

Bendamustine

28
Q

What are examples of monoclonal antibodies used in CLL?

A

Rituximab

Obinatuzumab

29
Q

What are poor prognostic markers for CLL?

A 
Advanced disease (Binet B or C)
Atypical lymphocyte morphology
Rapid lymphocyte doubling time <12 months
CD38+ expression
Loss/mutation of P53
Unmutated IgVH gene
30
Q

What are the 4 stages of lymphoma?

A

Stage I - One site
Stage II - One other site
Stage III - Many sites only lymph nodes
Stage IV - Extranodal involvement

31
Q

What staging system is used for lymphoma?

A

Ann Arbor

32
Q

How is non-Hodgkin lymphoma classified?

A

Lineage - B or T cell

Grade

33
Q

What is low grade lymphoma?

A

Indolent, often asymptomatic

Responds to chemotherapy but incurable

34
Q

What is high grade lymphoma?

A

Aggressive, fast-growing
Require combination chemotherapy
Can be cured

35
Q

What are the 2 commonest lymphomas?

A

Diffuse large B-cell lymphoma

Follicular lymphoma

36
Q

Is Diffuse large B-cell lymphoma low or high grade?

A

High grade

37
Q

Is follicular lymphoma low or high grade?

A

Low grade

38
Q

How are non Hodkin lymphoma treated?

A

Combination chemotherapy - anti-CD20 monoclonal antibody and chemotherapy

39
Q

Do men or women get Hodkin lymphoma more?

A

Men

40
Q

How is Hodgkin lymphoma treated?

A 
Combination chemotherapy
\+/- radiotherapy
Monoclonal antibodies (anti-CD30)
Immunotherapy (checkpoint inhibitors)
PET scanning to assess response to treatment

Haematology and immunology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions