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PHRM 864 therapeutics > Lymphoma Therapeutics > Flashcards

Lymphoma Therapeutics Flashcards

1
Q

Where are hematologic malignancies located

A

blood, bone marrow, lymph nodes

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2
Q

how is hodgkins lymphoma (HL) characterized

A

Reed Sternberg Cells

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3
Q

what are the risk factors for HL

A

EBV, impaired immune function (HIV)

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4
Q

how does HL present

A

pruritus
B symptoms (fever, night sweats, unintentional weight loss)

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5
Q

what is the gold standard for diagnosing HL

A

excisional nodal biopsy

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6
Q

How is HL staged

A

early stage favorable
early stage unfavorable
advanced stage

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7
Q

what are the unfavorable factors for HL

A

-large mediastinal adenopathy
-multiple involved nodal regions
-B symptoms
-extranodal involvement
-elevated ESR rate

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8
Q

what is the goal with HL

A

cure with minimal toxicities and long term complications

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9
Q

how does neutropenia affect the treatment of HL patients

A

continue to treat despite neutropenia

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10
Q

how to treat early stage favorable HL

A

ABVD + Radiation
(Doxorubicin, Bleomycin, Vinblastine, Dacarbazine)

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11
Q

what are toxicities associated with doxorubicin

A

cardiotoxicity

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12
Q

what are toxicities associated with bleomycin

A

pulmonary toxicity

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13
Q

what is the treatment for early stage unfavorable HL

A

ABVD + radiation

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14
Q

what is the treatment for advanced stage HL

A

ABVD + radiation or
AAVD (doxorubicin, brentuximab, vinblastine, dacarbazine)

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15
Q

how many cycles of ABVD chemo should be used in HL

A

2-4 cycles in early
6-8 cycles in advanced

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16
Q

how to treat relapsed HL

A

high dose chemo followed by autologous stem cell rescue

17
Q

what are risk factors for non-hodgkin lymphoma (NHL)

A

infections (EBV, herpes virus, h. pylori) or immunodeficiency

18
Q

how to confirm diagnosis

A

excisional biopsy is best

19
Q

describe follicular lymphoma

A

Indolent growing, not typically curable

20
Q

when to treat follicular lymphoma

A

only if patient is symptomatic or patient preference

21
Q

what can follicular lymphoma turn into

A

Via Richter’s transformation, follicular lymphoma can turn into an aggressive NHL

22
Q

what should be tested in diffuse large b-cell lymphoma (DLBCL)

A

double/triple hit (MYC, BCL2, BCL6)

23
Q

what is the treatment for stage I/II DLBCL

A

R-CHOP + Radiation 3 cycles
R-CHOP 6 cycles

24
Q

what is the treatment for stage III/IV DLBCL

A

R-CHOP 6 cycles or
Pola + R + CHP 6 cycles

25
Q

what is R-CHOP

A

rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

26
Q

what are toxicities in R-CHOP regimens

A

neutropenia
thrombocytopenia

27
Q

what is a concern with rituximab

A

Hepatitis B reactivation

28
Q

what must be tested prior to the start of anti-CD20 therapy

A

Hepatitis B Surface Antigen and Hepatitis B Core Antibody

29
Q

if a patient tests positive for HepB surface antigen or core antibody what should they be started on

A

Entecavir

30
Q

How should relapsed DLBCL/Aggressive NHL be treated

A

-Salvage chemo followed by autologous stem cell rescue or CAR-T
-palliative chemo
-BiTE

31
Q

Describe Multiple Myeloma (MM)

A

abnormal clonal plasma cells infiltrating the bone marrow
secrete immunoglobulins that reek havoc

32
Q

what is the presentation for multiple myeloma

A

CRAB
Calcium > 11.5
Renal Dysfunction Scr > 2 or CrCl < 40
Anemia < 10 or 2 less than normal
Bone: osteolytic lesions or fractures

33
Q

what is the treatment goal of MM

A

disease control
1st time treatment needs to be the best, won’t respond as well down the road

34
Q

treatment plan for MM

A

induction (remission) –> consolidation (transplant) –> maintenance

35
Q

when treating MM what you must determine about the patient

A

are they a stem cell candidate>

36
Q

what is the 3 drug regimen for MM

A

VRD (Lenalidomide, Dexamethasone, Bortezomib)

PHRM 864 therapeutics (10 decks)

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