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Hematology/Immunology Part 2 > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

What is lymphoma primarily characterized by?

A

Solid tumors in lymphoid tissue

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2
Q

How are lymphomas classified?

A

By cell type, either B-cell or T-cell

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3
Q

What is the primary function of B-cell lymphomas?

A

Related to humoral immunity and antibodies

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4
Q

What is a hallmark symptom of lymphoma?

A

Lymphadenopathy

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5
Q

What is essential for diagnosing lymphomas?

A

Excisional biopsy

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6
Q

Why is staging important in lymphoma diagnosis?

A

To determine prognosis and therapy

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7
Q

What classification system is used for staging lymphomas?

A

Ann Arbor Classification

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8
Q

What percentage of lymphomas are Non-Hodgkin Lymphomas (NHL)?

A

90%

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9
Q

What is the age distribution pattern for Hodgkin’s Lymphomas?

A

Bimodal distribution

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10
Q

What are B-symptoms in lymphoma?

A

Fever, weight loss, night sweats

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11
Q

What is a common diagnostic method for lymphoma?

A

Biopsy

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12
Q

What is a significant complication of lymphoma treatment?

A

Neutropenic fevers

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13
Q

What is the role of the lymphatic system in lymphoma?

A

Involves primary and secondary lymphoid organs

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14
Q

What is a common site for extranodal lymphoma?

A

Gastrointestinal tract

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15
Q

What is a typical presentation of lymphoma in physical exams?

A

Non-tender, hard, and firm lymph nodes

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16
Q

What is the significance of elevated LDH in lymphoma patients?

A

Indicates abnormal lab results

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17
Q

What is the most common type of Non-Hodgkin Lymphoma?

A

Diffuse Large B Cell Lymphoma (DLBCL)

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18
Q

What is the importance of staging in lymphoma?

A

Determines the extent and spread of the disease

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19
Q

What is a common imaging study used in lymphoma diagnosis?

A

CT scans

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20
Q

What is the purpose of a bone marrow biopsy in lymphoma?

A

To check for bone marrow involvement

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21
Q

What is a genetic factor associated with lymphoma?

A

EBV driven

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22
Q

What infections are linked to Non-Hodgkin Lymphoma?

A

EBV, HIV, Hep C, H. pylori

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23
Q

What is the lifetime risk of developing Non-Hodgkin Lymphoma for males?

A

1 in 46

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24
Q

What type of lymphoma is associated with a high rate of histologic transformation to a more aggressive form?

A

Follicular Lymphoma (FL)

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25
Q

What type of lymphoma originates in epithelial cells and is often associated with H. pylori infection?

A

MALT lymphoma

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26
Q

What type of lymphoma is highly aggressive and more common in children and immunosuppressed individuals?

A

B-cell lymphoma

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27
Q

What is the primary mechanism by which radiation therapy affects cells?

A

It breaks DNA, generating free radicals that damage cells.

28
Q

What are some acute side effects of radiation therapy?

A

GI tract issues, skin problems, and bone marrow damage.

29
Q

What is a mandatory part of the initial evaluation for highly aggressive B-cell lymphoma?

A

Examination of cerebral spinal fluid

30
Q

What chronic conditions can result from radiation therapy?

A

Thyroid dysfunction, cataracts, retinal damage, lung fibrosis, and secondary malignancies.

31
Q

What is the prognosis for Burkitt’s Lymphoma if treatment is delayed?

A

Adversely affected

32
Q

How does chemotherapy primarily target cancer cells?

A

By affecting DNA structure or segregation during mitosis.

33
Q

What is the typical treatment regimen for highly aggressive B-cell lymphoma?

A

Combination chemotherapy with high doses of Cyclophosphamide

34
Q

What are common side effects of chemotherapy?

A

Diarrhea, mucositis, nausea, alopecia, and infertility.

35
Q

What is the peak age distribution for Hodgkin’s Lymphoma?

A

Age 20 and age 65

36
Q

What is myelosuppression and its consequence in chemotherapy?

A

It causes pancytopenia, affecting leukocytes, platelets, and RBCs.

37
Q

What virus is associated with an increased risk of Hodgkin’s Lymphoma?

A

Epstein-Barr Virus (EBV)

38
Q

How is anemia associated with chemotherapy managed?

A

By transfusions of red blood cells.

39
Q

What has emerged as the dominant treatment option for R/R DLBCL?

A

Targeted therapies

40
Q

What is the purpose of stem cell transplantation in cancer treatment?

A

To replace damaged or destroyed bone marrow.

41
Q

What factors inform the choice of therapy for R/R DLBCL?

A

Type and response to prior therapies, timing of relapse, patient age, fitness, comorbidities, disease kinetics, and product availability

42
Q

What are some reliable sources for information on cancer?

A

American Cancer Society, Leukemia & Lymphoma Society, Goldman’s Cecil Medicine, UptoDate

43
Q

What distinguishes autologous from allogenic stem cell transplants?

A

Autologous uses the patient’s own stem cells; allogenic uses another individual’s stem cells.

44
Q

Where can one find detailed medical information on Non-Hodgkin’s and Hodgkin’s Lymphoma?

A

Goldman’s Cecil Medicine and UptoDate

45
Q

What is the treatment of choice in the third line and later for eligible DLBCL patients?

A

CAR T-cells

46
Q

What is the role of CD19-directed CAR T cell therapy?

A

It targets CD19 on cancer cells using engineered T cells.

47
Q

What are the key features of glofitamab in R/R DLBCL therapy?

A

It is a bispecific antibody targeting CD20 and CD3.

48
Q

What are second-line therapy options for patients ineligible or declining CAR T-cell therapy?

A

Tafasitamab/lenalidomide, polatuzumab/BR, or chemoimmunotherapy (R-GemOx)

49
Q

What is unique about epcoritamab administration?

A

It is a subcutaneously administered CD3 x CD20 bispecific antibody.

50
Q

What are third-line and later-line options for patients who have progressed on CAR T-cell therapy?

A

Tafasitamab/lenalidomide, polatuzumab/BR, loncastuximab tesirine, and selinexor

51
Q

What can be considered for selected patients in R/R DLBCL therapy?

A

Ibrutinib or pembrolizumab

52
Q

What is an emerging off-the-shelf immunotherapy option?

A

Bispecific monoclonal antibodies

53
Q

What is a medical emergency related to neutrophils?

A

Neutropenic fevers

54
Q

What is the ANC threshold for neutropenia?

55
Q

What unique cell type is characteristic of Hodgkin’s Lymphoma?

A

Reed-Sternberg cells

56
Q

What are common symptoms of Hodgkin’s Lymphoma?

A

Fevers, night sweats, and weight loss

57
Q

What should be initiated immediately in the case of neutropenic fevers?

A

Empiric broad-spectrum antibiotics

58
Q

What is the most common histology type of Hodgkin’s Lymphoma?

A

Nodular sclerosis classical HL (NSHL)

59
Q

What is the first line treatment for Hodgkin’s Lymphoma?

A

Chemotherapy and/or radiation

60
Q

What is the goal of lymphoma treatment?

A

Cure/Remission or Palliation

61
Q

What is the next treatment option if conventional lymphoma treatments fail?

A

Stem Cell Transplant

62
Q

What does Complete Remission (CR) mean in lymphoma treatment?

A

No evidence of disease or disease-related symptoms

63
Q

What does Partial Remission (PR) indicate in lymphoma treatment?

A

Regression of disease by at least 50% reduction in nodal size

64
Q

What are bispecifics used in NH Lymphoma treatment?

A

CD20/CD3 - Glofitamab and Epcoritamab

65
Q

What syndrome involves rapid release of intracellular potassium and phosphorous?

A

Tumor Lysis Syndrome (TLS)

66
Q

What are the key diagnostic tests for Tumor Lysis Syndrome?

A

Liver function test, LDH, uric acid, renal function test, serum electrolytes, EKG

Hematology/Immunology Part 2 (9 decks)

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