Lymphoma Flashcards
What are some symptoms of lymphoma?
Lymphadenopathy
Fatigue
Itching
Feeling ill when drinking alcohol
Fevers
Weight loss
What is lymphoma?
Cancer of the lymphatic system (lymph nodes, spleen, thymus, and bone marrow)
Categorised into
- Hodgkin lymphoma
- Non-Hodgkin lymphoma (NHL)
What test is done to work out if the cause of renal failure in pre-renal, renal, or post-renal?
Ultrasound of the kidney
What medication can be given to treat hypercalcaemia?
Bisphosphonates beside rehydration
What is the first line chemotherapy drug for lymphoma?
Retuximab
After a lymphoma tumour has been treated, how will it leave the body?
Through the kidneys
The proteins will break down from amino acids into uric acid
What is tumour lysis syndrome?
When the break down products of cancer cause electrolyte imbalances that lead to
- Acute kidney injury
- Cardiac arrhythmias
- Nausea and vomiting
- Seizures
How is tumour lysis syndrome treated?
Intense hydration and Allopurinol
(To break down the uric acid)
Which infections can cause lymphoma?
- HTLV-1 (Human T-lymphotropic virus 1)
- EBV
- Helicobacter Pylori
How are lymphomas staged?
Using the Ann Abor system
Stage I- Single Site
Stage II- 2 Sites, Same side
Stage III - Both sides
Stage IV - Diffuse
What are some histological subtypes of lymphoma?
-Lymphocyte Predominant (9%)
-Nodular Sclerosis (63.6%)
-Mixed cellularity (22.7%)
-Lymphocyte depleted (4.5%)
What are the risks for developing lymphoma?
- 40% of cases are linked to EBV
- Immunodeficiency (HIV)
What is R-CVP?
The combination of cancer drugs used to treat low grade non-Hodgkin lymphoma
R – rituximab
C – cyclophosphamide
V – vincristine
What is pancytopenia?
Low levels of all 3 types of red blood cell:
Red blood cell
White blood cell
Platelet
What is thrombocytopaenia?
Low platelet count
What is the difference between Hodgkin’s and Non-Hodgkin’s lymphoma?
Hodgkin’s lymphoma presents with Reed-Sternberg cells, Non-Hodgkin’s doesn’t
What is R-CHOP chemo therapy?
A type of chemoimmunotherapy used to treat non-Hodgkin’s Lymphoma
Combines (rituximab [Rituxan®], cyclophosphamide [Cytoxan®], doxorubicin [hydroxydoxorubicin], Oncovin® [vincristine] and prednisone)
What is stereotactic radiotherapy?
Therapy given from lots of different directions to avoid damaging healthy tissue and reduce side effects
What are the uses of Denosumab?
It’s used to treat osteoporosis and it helps prevent bone metastases in cancer
Great drug because it reduces cancer progression and reduces risk of pathological fractures and osteoporosis caused by treatment
What are B and E symptoms?
E = Extranodal site / Extension
B = Constitutional symptoms (Weight Loss, Night Sweats, Fever)
Included in staging of lymphoma
What is the difference between leukaemia and lymphoma?
Leukaemia is malignancy of the bone marrow, lymphoma is outside the bone marrow
What is the clinical presentation of lymphoma?
- B symptoms (fatigue, night sweats, fever, weight loss)
- Dyspnoea, cough, chest pain (due to mediastinal involvement
- Bruises and anaemia
- Jaundice and itchy skin (due to abdominal involvement)
How does alcohol affect lymphoma?
Causes pain at nodal signs
- Classic presentation that is not often seen
What are the differentials for lymphoma?
- TB
- Leukaemia
- HIV (AIDS)
- Infectious mononucleosis
- Toxoplasmosis
- Myeloma
- Other viral infection
What is the difference in management of Hodgkin’s and non-Hodgkin’s lymphoma?
Hodgkin’s:
- Radiotherapy and chemotherapy
non-Hodgkin’s:
- Chemotherapy
- Biologics, radiotherapy, bone marrow transplant
What are the different types of Hodgkin’s lymphoma?
Most common:
- Nodular sclerosis
Other:
- Mixed cellularity
- Lymphocyte-rich
- Lymphocyte-depleted (aggressive)
What are the 2 categories of Hodgkin’s lymphoma?
- Classical Hodgkin’s lymphoma (95%)
- Nodular lymphocyte-predominant Hodgkin’s lymphoma
What are the 2 categories of non-Hodgkin’s lymphoma?
- T-cell
- B-cell
What are the types of B-cell non-Hodgkin’s lymphoma?
Most common:
- Diffuse large B-cell lymphoma (DLBCL)
- Follicular lymphoma
Other:
- Mantle cell lymphoma
- Burkitt’s lymphoma
- Primary CNS lymphoma
- Marginal cell lymphoma
- Precursor B-lymphoblastic lymphoma
What are the types of T-cell lymphoma?
- Anaplastic large-cell lymphoma
- Peripheral T-cell lymphoma
- Mycosis fungoid
- Cutaneous T-cell lymphoma
- Precursor T-lymphoblastic lymphoma
How common is T-cell lymphoma compared to B-cell lymphoma?
15%
What are primary extra nodal lymphomas (pENL)?
Lymphomas that begin outside of the lymph nodes, most commonly the stomach and small bowel
Eg. diffuse large B-cell lymphoma, and extra nodal marginal B-cell lymphoma
How does lymphoma begin?
An uncontrolled proliferation of B or T cells
Caused by genetic factors, infections, and environment
What are the complications of lymphoma?
Disease related:
- Obstruction (Eg. superior vena cava, bowel)
- Pain
- Pericardial effusion or pleural effusion
Treatment related:
- Neutropenic sepsis
- Diarrhoea and vomiting
- Anorexia and weight loss
- Tumour lysis syndrome
- Infertility
- Toxicity and impairment of organs
- Secondary cancers
