Lymphoma: HL and NHL Flashcards
What is lymphoma?
• Malignant neoplasms originating in the bone marrow and lymphatic structures
What are the two types of lymphoma?
• Hodgkin’s and Non-Hodgkin’s
Hodgkin’s lymphoma generally affects people of what age?
• Most common in 20’s, increasing again after 55
Which type of lymphoma has the presence of Reed-Sternberg cells?
• Hodgkin’s lymphoma (main dx feature)
Where does Hodgkin’s lymphoma typically start?
- In a single lymph node
* Usually in/around the neck
Although the cause of Hodgkin’s lymphoma is unknown, what are some key factors thought to be involved in its development?
- Epstein-Barr virus (mono)
- The immunosuppressed
- Genetics
- Exposure to occupational toxins
How does alcohol correlate to s/s of Hodgkin’s lymphoma?
• May complain of a rapid onset of pain at the site of disease after ingestion of even small amounts of alcohol
Mediastinal node involvement of Hodgkin’s lymphoma may present w/ what s/s?
- Cough
- Dyspnea
- Stridor
- Dysphagia
Hepatomegaly, splenomegaly and anemia may be seen in ______ cases of Hodgkin’s lymphoma.
• Advanced
What dx studies are done for dx of Hodgkin’s lymphoma?
- Excisional lymph node biopsy
- Bone marrow examination
- Radiologic evaluation
What dx test is used for initial staging of Hodgkin’s lymphoma?
• CT/MRI
What is ABVD and BEACOPP?
• Anagrams for the combination of drugs used for chemotherapy
Regarding ABVD and BEACOPP, which is for advanced stage and which is standard?
- ABVD = standard
* BEACOPP = advanced
How is the effectiveness of chemotherapy for lymphoma determined?
• By use of CT, PET scans and bone marrow biopsy
True or False
Radiation therapy for lymphoma should be gradual and incrementally increased.
• False, it must be aggressive
True or False
Maintenance chemotherapy contributes to an increased survival once a complete remission has been achieved
• False, it does not contribute to an increased survival rate
How many cycles of chemotherapy would an early favorable stage of lymphoma receive?
• 2-4 cycles
How many cycles of chemotherapy would an early unfavorable stage of lymphoma receive?
• 4-6 cycles
How many cycles of chemotherapy would an advanced stage of lymphoma receive?
• 6-8 cycles
True or False
Hodgkin’s lymphoma has a better overall prognosis than many cancers.
• True
Early-stage Hodgkin’s lymphoma has a 5-year survival rate of over 90%, and even advanced-stage Hodgkin’s lymphoma has a 5-year survival rate of more than 80% with aggressive therapy.
- Early-stage = 90%
* Advanced stage = 80%
True or False
Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma.
• True
What age group is affected by Non-Hodgkin’s lymphoma?
• All
What is Non-Hodgkin’s lymphoma?
- A group of malignant neoplasms of the immune system affecting all ages
- Primarily B- and T-cell origin
What is the progression speed of Non-Hodgkin’s lymphoma?
• Can happen fast or slow
Where does NHL usually start?
• It can begin anywhere in the body
What are the risk factors for NHL?
- immunosuppression or immunodeficiency
- Family hx
- Infections agents
- EBV
- H. Pylori
Although NHL’s cause is unknown, it has been most common in those who have used _____ meds or have received _____ or _____.
- Immunosuppressive
* chemotherapy or radiation
True or False
All NHLs involve lymphocytes arrested at various stages of development
• True
True or False
NHL originates in the lymph node and its spread is predictable once diagnosed
• False, it can originate outside the lymph node and is unpredictable in how it spreads.
Initial NHL symptoms that correlate with a worse prognosis are called “B Symptoms”. List them.
- Fever
- Night sweats
- Weight loss
What are the other general s/s of NHL?
- Painless, swollen lymph nodes in your neck, armpits or groin
- Abdominal pain or swelling
- Chest pain, coughing or trouble breathing
- Persistent fatigue
Does NHL related weight loss occur at the early or late stage?
• Late
Tumors in the mediastinum can cause
• Respiratory distress
Abdominal masses can cause
• Renal dysfunction and blockage of the ureters
Splenomegaly can cause
• Abdominal discomfort and pain
What is Tumor Lysis Syndrome (TLS)?
• A condition that happens when cancer cells die quickly (as a result of radiation/chemotherapy
Why is TLS dangerous?
- Dying cells release large amounts of potassium, phosphate, and uric acid into the blood.
- This can cause heart or kidney problems and lead to heart/kidney failure.
- TLS can become life-threatening if is not managed or treated
What are the unique s/s of TLS?
- Muscle weakness, cramps, or spasms
- Tingling around the mouth or in the hands or feet
- Palpitations the heart feels like it beating faster or slower
- Seizures
How is TLS dx’d?
• Blood tests for: K, Ca, Phos, and Uric Acid levels
Which has a generally better prognosis, HL or NHL?
• HL
Which has a longer life expectancy, an aggressive or indolent lymphoma?
• Patients with low-grade (indolent) lymphoma may live only 5 years, while others with more aggressive lymphomas may live 30 years or longer as it is more responsive to tx.
What are the main therapies used to treat lymphoma?
- Chemotherapy
- Radiation
- Hematopoietic stem cell transplant
What is R-CHOP?
• An anagram for meds used in the most common chemotherapy regimen
What are complications of long-term chemotherapy?
- Literally, everything.
* The system is immunocompromised so at risk for all things bad
What our nursing care consist of for the pt w/ lymphoma receiving chemo/radiologic therapy?
- Largely based on managing problems related to the disease, pancytopenia, and other side effects
- Skin in the radiation field requires special attention
- Psychosocial considerations
- Fertility concerns
