Lymphoma II Flashcards
What are the ages of Hodgkin’s lymphoma?
20-30, then >50
Who gets hodgkin’s lymphoma?
Male caucasians
What is the survival rate of Hodgkin’s disease?
85%
What are the two associated infectious agents with Hodgkin’s lymphoma?
EBV and HIV
What are the ssx of Hodgkin’s disease?
fevers/chills/night sweats/weight loss
Pruritis
EtOH induced pain in lymph nodes
What are the common areas of lymphadenopathy of Hodgkin’s disease?
70% cervical
60% mediastinal
What is the major difference in lymphadenopathy between Hodgkin’s and NHL?
Contiguous in HL
True or false: unilateral bone marrow biopsy for HL is sufficient
True
What is stage I HD?
1 nodal region or lymph node
What is stage II HD?
2 or more nodal regions on the same side of diaphragm
What is stage III HD?
Both sides of the diaphragm
What is stage IV HD?
> 1 extranodal sites
What is a Reed Sternberg cell?
B cell origin with multinuclei (owl eyes)
What are the two CD markers for HD?
CD15 and CD30
What are the markers for adverse prognostic factor for HD?
Albumin 15
Hb
What is the prognosis for HL disease?
Very good
What are the treatments for HD?
Chemo + XRT. One alone if low grade, both if advanced
Which is more common: NHL or HL?
NHL
Who is usually affected by NHL?
Adult, white men
What are the two types of NHL?
B cell (85%) and T cell (15%)
What is the 5 year survival for NHL?
67%
What are the infectious agents that are implicated with NHL?
EBV HTLV-1 HCV HHV8 H.pylori
What are the occupations/exposures of NHL? (3)
Agriculture
Benzene exposure
Prior Chemo/radiation
What are the ssx of NHL?
b-sx, but more symptoms if aggressive
When is an LP indicated for NHL?
testicular, nasopharyngeal involvement
What is the translocation for follicular lymphoma? Oncogene?
t(14;18)
bcl-2
What is the translocation for SLL? Oncogene?
t(14;19)
bcl3
What is the translocation for mantle cell lymphoma? Oncogene?
t(11;14)
bcl1
What is the translocation for burkitt’s lymphoma? Oncogene?
t(8;14)
myc
What is the translocation for DLCL? Oncogene?
t(3;14)
bcl6
What are the two very aggressive NHLs?
Burkitt’s
Any T cell
What is diffuse large cell lymphomas?
Rapidly enlarging mass with extranodal sites
What is the overall cure rate of diffuse large cell lymphoma?
45%
What are the prognostic factors for diffuse large cell NHL?
LDH elevated
Age >60
>1 extranodal site
What is the treatment for diffuse large cell NHL?
Chemo + rituxan
NOT surgical
What is the chemo treatment for DLCL?
Cyclophosphamide
Adriamycin
Vincristine
Prednisone
What is the MOA of rituximab?
Anti CD20 ab that targets DLCL
What is small lymphocytic lymphoma? (ssx)
Indolent CA with enlarging LN over months to years
Usually asymptomatic
Who gets SLL?
Late to middle aged
What is the prognosis for SLL?
Incurable
What is Richter’s transformation?
about 35% of follicular lymphomas will transform into DLCL at 10 years of disease
What is the treatment for indolent lymphoma, SLL?
Curative radiation therapy if early stages
Palliative radiation + chemo if advanced stages
What are the three very aggressive NHLs?
Lymphoblastic lymphoma
Burkitt’s lymphoma
Any T cell lymphoma
Who usually gets very aggressive NHL?
Peds and young adults
What is the prognosis for very aggressive NHLs?
Curable, but very aggressive
Who gets a stem cell/BM transplant for aggressive lymphoma? What type of transplant is this?
DLCL, follicular, and very aggressive lymphomas
Autologous stem cells
What is MALT lymphoma? Where is this usually found?
Mucosa associated lymphoid tissue lymphoma
GI tract, lungs, breasts
What is the treatment for MALT d/t h.pylori?
usual treatment for H.pylori
Chemo if not spontaneous remission after
What are the three HIV associated lymphoma?
DLCL
Burkitt’s
CNS lymphoma
Where are HIV associated lymphoma found?
Anus/rectum
Soft tissues
What is the major prognosis factor for HIV associated lymphoma?
Low CD4 counts
Who gets CLL?
Older pts with immunodeficiency conditions
Which type of lymphocyte is associated with CLL?
B cells
Where is CLL found in the body?
Always in bone marrow and peripheral blood
What are the ssx of CLL?
Asymptomatic to infectious symptoms
Lymphadenopathy/splenomegaly
What are the labs like i CLL?
Leukocytosis
Low IgG, IgA and IgM
What are the CD markers for CLL?
CD5
CD20
CD23
What is stage 0 - 4 of CLL?
0 = lymphocytosis 1 = Lymphadenopathy 2 = Splenomegaly 3 = Anemia 4 = thrombocytopenia
What is the prognosis for CLL? Treatment?
Not curable, but treat with chemo when high stage or very symptomatic