lymphoma

Question 1

what is lymphoma?

Answer 1

clonal proliferation of lymphocytes arising in a lymph node or associated tissue
solid tumour but some cells in blood

Question 2

what are the 3 types of lymphoma?

Answer 2

Hodgkin
non-Hodgkin
-more common 6:1

Question 3

what are the symptoms of lymphoma?

Answer 3

fever
swelling of face and neck
lump in neck, pits, groin
excessive sweating at night
unexpected weight loss
breathlessness
weakness
loss of appetite
itchiness

Question 4

what is the staging of lymphoma?

Answer 4

requires imaging

• CT, PET/CT or MRI
  1. no. nodes involved and site
  2. extra-nodal involvement
  3. systemic symptoms

Question 5

what is the purpose of staging?

Answer 5

predicting prognosis and deciding tx

Question 6

describe hodgkin lymphoma

Answer 6

peak 15-40 years

M:F 2:1

Question 7

what is the clinical presentation of hodgkin lymphoma?

Answer 7

painless lymphadenopathy- typically cervical, fluctuate in size pain with alcohol notable
fever, night sweats. weight loss, itching
infection

Question 8

what are the cure prognosis of stage 1 and 2 hodgkin lymphoma

Answer 8

> 90%

Question 9

what is the cure prognosis for stage 3 & 4 hodgkin?

Answer 9

50-70%

Question 10

describe non-hodgkin lymphoma

Answer 10

B-cell (85%)
T-cell (15%)
any age

Question 11

what is the aetiology of non-hodgkin?

Answer 11

microbial factors strongly implicated
-EBV, HIV, H.pylori
autoimmune disease associated 
-chronic immune activation
immunosuppression

Question 12

what is the presentation of NHL?

Answer 12

lymphadeopathy
-often disseminated
extra-nodal disease
-oropharyngeal involvement
waldeyers ring
-noisy breathing sore throat
symptoms of marrow failure
constitutional symptoms less common (fever, sweat etc.)

Question 13

what is the prognosis of NHL?

Answer 13

> 50% relapse
aggressive disease
poor prognosis untreated

Question 14

what is a multiple myeloma?

Answer 14

malignant proliferation of plasma cells

Question 15

what are the features of multiple myeloma?

Answer 15

monoclonal paraprotein in blood and urine
lytic bone lesions-pain & fracture
excess plasma cells in bone marrow - marrow failure

Question 16

what are the signs of multiple myeloma?

Answer 16

infection
bone pain
renal failure
-paraproteins clog renal glomerular
-form clumps in organs & tissues reducing function
amyloidosis
-in GIT prevents absorption

Question 17

what is the tx of haematological malignancies?

Answer 17

chemo
radiotherapy
monoclonal antibodies
haemopoietic stem cell transplantation

Question 18

what are the stages of tx?

Answer 18

induction
-large dose chemo to remove disease
remission
-normal marrow
maintenance & consolidation
-require low level tx for many years
relapse 
-disease comes back

Question 19

what is included in supportive therapy?

Answer 19

nutrition
psychological and social support
prevention and tx of infection
managing symptoms of side effects
correcting marked blood component deficits
pain control

Question 20

describe chemo

Answer 20

cells with high turnover rate targeted
responsible for many unwanted effects in notmal high turnover tissues
side effects
long-term risk of oncogenesis

Question 21

describe radiotherapy

Answer 21

cytotoxic effect of ionizing radiation
-beam directed outside body
-adjacent healthy tissue affected
-spactial positioning, targeting and dosing techniques minimises
risk of inducing late cancers

Question 22

describe monoclonal antibodies?

Answer 22

specific to cancer cell antigens produced artificially in large quantities
use CD antigens on white cells
target interleukin messaging
target GF

Question 23

describe haemopoietic stem cell transplant

Answer 23

allogenic=from live donor
autologous=from px
require total body irrdiation
-remove marrow and maglignant cells
usually stem cells from blood
high risk