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Oncology Exam 3 > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

Proliferation of what 2 cells can cause non-hodgkins lymphoma?

A
  1. T cells
  2. B cells
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2
Q

What is the median age for lymphoma diagnosis?

A

56

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3
Q

What patient population is lymphoma most common in?

A

White males

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4
Q

What are 3 risk factors for lymphoma? (First slide)

A
  1. Genetic immunodeficiency
  2. Immunosuppression (acquired or chronic)
  3. Autoimmune diseases
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5
Q

What are 3 risk factors for lymphoma? (Second slide)

A
  1. Infection
  2. Radiation
  3. Chemicals
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6
Q

What 4 infections can cause lymphomas?

A
  1. Epstein Barr virus
  2. Human T cell lymphotroptic virus type 1
  3. Kaposis sarcoma
  4. Helicobacter pylori
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7
Q

What are the 3 types of lymphomas?

A
  1. Indolent
  2. Aggressive
  3. Highly aggressive
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8
Q

What are 2 sites of involvement that can help determine the clinical presentation of lymphomas?

A
  1. Lymph nodes
  2. Bone marrow
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9
Q

What is the most important factor for prognosis of NHL?

A

Subtype

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10
Q

What are the 5 criteria’s for prognosis?

A
  1. Subtype
  2. Stage
  3. Performance status
  4. Tumor burden
  5. International prognostic index (IPI)
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11
Q

Slow growing disease with ‘favorable’ survival rates

A

Indolent

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12
Q

True or False: indolent lymphomas are incurable with standard therapies

A

True

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13
Q

What are 2 pharmacological treatments that are used for indolent lymphomas?

A
  1. Rituximab + Bendamustine
  2. Rituximab only
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14
Q

What is the MOA of Rituximab?

A

Anti-CD20 monoclonal antibody

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15
Q

What are 2 main ADRs shown with Rituximab?

A
  1. Infusion site reactions
  2. Reactivate latent infections
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16
Q

Fast growing disease with high cell turnover

A

Aggressive lymphoma

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17
Q

True or False: Aggressive lymphomas are incurable

A

False (potentially curable)

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18
Q

What is the standard regimen for aggressive lymphomas?

A

RCHOP

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19
Q

What does RCHOP stand for?

A
  1. Rituximab
  2. Cyclophosphamide
  3. Doxorubicin
  4. Vincristine
  5. Prednisone
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20
Q

What are 2 other regimens that can be used for aggressive lymphomas?

A
  1. R-CVP
  2. R-EPOCH
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21
Q

How many cycles of R-CHOP do patients get?

A

6-8

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22
Q

What is the main toxicity for vincristine?

A

Peripheral neuropathy

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23
Q

What is the main ADR of doxorubicin?

A

Cardiac toxicity

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24
Q

What drug is not used for relapsed and refractory tumors?

A

Anthracyclines

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25
What are 3 options for treating indolent tumors?
1. Observations 2. Locoregional radiotherapy 3. Chemotherapy
26
What are 3 other treatments, beside chemotherapy, that can be used for relapsed and refractory treatments?
1. Radioimmunotherapy 2. Bone marrow transplantation 3. Chimeric antigen receptor T cell (CAR-T)
27
What protocols are the highly aggressive lymphomas based on?
Pediatric
28
What patient population is highly curable for highly aggressive lymphomas?
Children
29
What are 2 other regimens that can be used, besides chemotherapy, for highly aggressive lymphomas?
1. CNS prophylaxis 2. Cranial irradiation
30
What is not considered adequate therapy for highly aggressive lymphoma treatment?
R-CHOP
31
When are HIV-associated lymphomas present?
With profound B-symptoms
32
What is the median survival for HIV-associated Lymphomas?
<12 months
33
What are 3 treatment regimens for HIV-associated lymphomas?
1. Low dose regimens to decrease immune suppression 2. Concurrent antiretroviral therapy 3. CNS prophylaxis/ cranial irradiation
34
What kind of age distribution is shown with non-Hodgkins lymphomas?
Bimodal
35
What patient population has a higher incidence of Hodgkin’s lymphoma?
White males
36
What infection increases the risk of Hodgkin’s lymphoma?
Epstein Barr virus
37
True or false: patients with a higher socioeconomic background have a higher risk of developing Hodgkin’s disease
True
38
Large bilobate multi nuclear cells that are sometimes referred to as owls eyes
Reed-sternberg cells
39
What could reed sternberg cells be a possible fusion of? 3
1. Reticular cells 2. B cells 3. T cells
40
Enlarged, painless, rubbery lymph nodes involved in the clinical presentation of Hodgkin’s disease
Lymphadenopathy
41
What 3 things are associated with “B” symptoms?
1. Fever >38 C for unknown reasons 2. Drenching night sweats 3. Weight loss (unexplained)
42
What are 4 clinical presentations of Hodgkin’s disease?
1. Lymphadenopathy 2. B symptoms 3. Alcohol induced lymph node pain 4. Pruritus
43
True or False: Hodgkin’s disease has a non contiguous spread to adjacent lymph node chains
False
44
True or False: Hodgkin’s disease becomes more aggressive over time
True
45
What 3 places does Hodgkin’s disease spread?
1. Liver 2. Bone 3. Bone marrow
46
What is the most important for Hodgkin’s disease prognosis?
Stage
47
The presence of b symptoms has a ______ prognosis
Poorer
48
What gender has a poorer prognosis with Hodgkin’s disease?
Males
49
True or false: Younger patients have a poorer prognosis in Hodgkin’s disease
False (older)
50
What are 3 treatment options for Hodgkin’s disease?
1. Radiation 2. Chemotherapy 3. Combination of radiation and chemotherapy
51
What chemotherapy regimen is used for Hodgkin’s disease?
ABVD
52
What drugs are involved in **ABVD**?
1. Doxorubicin 2. Bleomycin 3. Vinblastine 4. Dacarbazine
53
For early favorable Hodgkin’s disease how many cycles of ABVD are needed?
2-4 cycles
54
For early unfavorable Hodgkin’s disease, how many cycles of ABVD are needed?
4-6 cycles
55
For early favorable Hodgkin’s disease what regimen is used?
ABVD + XRT
56
For early unfavorable Hodgkin’s disease, what regimen is used?
ABVD + XRT
57
For advanced favorable Hodgkin’s disease, what regimen is used?
ABVD only
58
For advanced favorable Hodgkin’s disease, how many cycles of ABVD are needed?
6-8 cycles
59
For advanced unfavorable Hodgkin’s disease, what regimen is used?
ABVD only
60
For advanced unfavorable Hodgkin’s disease, how many cycles of ABVD is needed?
6-8
61
What is an irreversible ADR of bleomycin?
Pulmonary fibrosis
62
What is the main ADR seen with vinblastine?
Peripheral neuropathy
63
What is needed when monitoring for Dacarbazine?
An echocardiogram
64
What drug can be used for refractory or relapsed Hodgkin’s disease?
Brentuximab vedotin
65
What is the pattern of spread for non Hodgkin’s lymphoma?
Non contiguous

Oncology Exam 3 (6 decks)

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