Lymphoma HL Flashcards
common age of hl
15-35 years in nodular sclerosis
after 50 years
immunohistochemistry in classical HL
CD 15, CD 30 positive
NLPHL: CD20, CD 45, CD 79a, BCL 6 positive
variant of RS cell
RS cell lacunar cell L&H cell RS like cell pleomorphic cell mummy RSC
WHO classification of HL
a. nodular: lymphocyte prodominant
b. classical HL:
nodular sclerosing
mixed cellularity
lymphocyte rich
lymphocyte depleted
Risk factors/prognostic factors of HL (NCCN)
large mediastinal mass
ESR>-50
>3 nodal site
overall survival of early stage disease
> 95% after 5 years or more
Radiotherapy dose for HL
disease limited stage, complete response: 20gy in 10 daily fraction
limited stage, incomplete response on CT
30 gy in 15 fraction
limited stage unfavorable group
30 gy 15 daily fraction
advance stage with residual PET positive
30-40 gy in 15-20 daily fraction
1st line chemo for HL
ABVD, MOPP, COPP, BEACOPP, STANFORD V
2nd line chemo for NHL
ICE, DHAP, ESHAP, GVD, IGEV, Brentuximab vedotin
ABVD details
doxorubicin 25 mg/m2 D1,D15
bleomycin 10 units/m2 d1,15
vinblastine 6mg/m2 d1,15
dacarbazine 375mg/m2 d1,15
ICE regimen for HL
ifosfamide 5000mg/m2 d2
carboplatin AUC 5 d2
etoposide 100mg/m2 d1-3
mesna 5000mg/m2 d2
BEACOP schedule baseline drugs
etoposide doxorubicin cyclophosphamide vincristine bleomycin procarbazine prednisolone
international prognostic score for advanced stage HL
WALSH AM: WBc, age, lymphocyte, stage, hb%, albumin, male
gender male
age >45
stage IV
albumin <4g/dl
HB% <10.5 g/dl
WBC > 15000
lymphocyte <600 ul
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Deauville criteria
1=no uptake 2=uptake below mediastinum 3=uptake above mediastinum below liver 4=uptake moderately higher than liver 5=uptake markedly higher than liver x= new areas of uptake unlikely to be related to lymphoma
Immunophenotype for CHL, NLPHL
Typical immunophenotype for CHL: (NCCN)
CD15+, CD30+, PAX-5+ (weak); CD3-, CD20- (majority), CD45-, CD79a-
.
Typical immunophenotype for NLPHL:
CD20+, CD45+, CD79a+, BCL6+, PAX-5+; CD3-, CD15-, CD30-
