Lymphomas and Leukemia

Question 1

What is the treatment option for hodgkins lymphoma

Answer 1

ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)
AAVD (doxorubicin, brentuximab vendotin, vinblastine, dacarbazine)
-follow w/autologous stem cell transplant

Question 2

What toxicities are associated with ABVD?

Answer 2

bleomycin - pulmonary toxicity
doxorubicin - cardiotoxicity
vinblastine - peripheral neuropathy
dacarbazine - myelosuppression

Question 3

What is follicular lymphoma?

Answer 3

• usually indolent, incurable
  -only tx if symptoms

Question 4

What are the first line therapies for symptomatic follicular lymphoma?

Answer 4

BR (bendamustine + rituximab)
R-CHOP (rituximab, cyclophosphamide, vincristine, prednisone)

Question 5

What is richter’s transformation?

Answer 5

follicular lymphoma turns into aggressive NHL
-treat like DLBCL

Question 6

What are the treatments for DLBCL?

Answer 6

R-CHOP
Pola + R + CHP (polatuzumab vendotin, rituximab, cyclophosphamide, doxorubicin, prednisone)

Question 7

What is the worry about rituximab?

Answer 7

can reactivate Hepatitis B
-test surface antigen and core antibody HepB

Question 8

How does multiple myeloma present?

Answer 8

CRAB
Calcium is high, renal dysfunction, anemia, bone lesions
-secretes IgG, igA but is dysfunctional

Question 9

What is the preferred treatment for multiple myeloma?

Answer 9

-determine if transplant candidate–autologous stem cell transplant
*VRD: bortezomib, lenalomide, dexamethasone
-use in transplant candidates
CyBorD: cyclophosphamaide, bortezomib, dexamethasone
Daratumumab, lenalomide, dexamethasone

Question 10

What toxicities are associated with Dasatinib?

Answer 10

-avoid acid reducers
-fluid retention (plueral effusion)

Question 11

What is the first line treatment for CLL?

Answer 11

Zanubrutinib, acalabrutinib
-BTK inhibitors may cause transient lymphocytosis

Question 12

What drug can cause tumor lysis in CLL?

Answer 12

Venetoclax
-drug interactions with CYP3A4 & P-gp

Question 13

What is first line treatment for AML?

Answer 13

induction phase: intensive chemotherapy (7+3) of cytarabine (7) + Doxorubicin/idrarubicin (3)

Question 14

What are the treatments if patient is positive for FLT3 mutation in AML?

Answer 14

midostaurin
2nd line: gilteritinib

Question 15

How do you treat APL?

Answer 15

all trans retinoic acid (ATRA) and Arsenic trioxide (ATO)

Question 16

What causes APL?

Answer 16

t(15;17) = PML:RARA

Question 17

What is first line treatment for AML?

Answer 17

HyperCVAD
hyper-fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone
+/- Blinatunomab; +/- pegaspargase