Lymphomas and Myeloma

Question 1

Describe lymphoma and multiple myeloma.

Answer 1

• uncontrolled differentiation
• lymphocytes
• heterogenous / chromosomal transduction

SYMPTOMS
- enlarged lymph nodes

Question 2

Identify and discriminate the two main types of lymphomas: Hodgkin and Non-Hodgkin

Answer 2

HODGKIN:
- clonal b-cell malignancy
- family history of HIV
- lymph node biopsy presents bi-lobe nucleated, enlarged Reed-Sternberg cell using microscopy

Question 3

Explain the molecular origin of Non-Hodgkin lymphomas.

Answer 3

• large lymph nodes with general lymphoma symptoms
• palpate enlarged lymph node
• chromosomal translocation in cancerous cells (heavy & light Ig chain in chromosome 14 & 18) w/ high expression in B-cell
  B-cells tissue specific enhancer which promotes expression of Ig = begins activating rearranged v segment of Ig
• 18 contains BCL-2 increases expression under enhancer influence = decreased apoptosis = increased survival and proliferation
• common origins from infectious agents (environmental?)/ viral infections HHV? LMB-1 oncogene => mostly prevented from cytotoxic T-cells (immunosurveillance)
  latent EBV = immunosuppressant = cytotoxic cells cannot attack = HIGH mutation risk

GRADES:
LOW: preserve tissue architecture, easily identifiable, slower division and present for long time before symptom development and diagnosis
HIGH: difficult cellular region / rapid division / clear symptoms / life threatening

Question 4

Discuss the main clinical and molecular characteristics of lymphomas and multiple myeloma

Answer 4

multiple myeloma = tumour of bone marrow w/ plasma cells
SYMPTOMS = bone pain, recurrent infection, bleeding, anaemia
RISKS: obesity, family hisotry, radiation exposure
- PATHALOGY: paraprotein precipitation amyloid in tissues = hyperviscosity syndrome in blood = stroke / heart failure
- stacking of RBC in blood morphology
- HIGH ESR (non-specific inflammation indicator)
flow cytometry / detect skeltal lesions/ urine electropheresis for detection
- release of cytokine IL-6 = Ca2+ release and bone resorbtion via stimulating RANK-L = increased osteoclast recruitment in bone stroma

Question 5

what is the most common chromosome translocations in Non-Hodgkin lymphoma>

Answer 5

CHR-14 & CHR-18
CHR-8 & CHR-14

Question 6

Discuss treatment therapy of Rutuximab

Answer 6

CD-20 receptor located on cancerous B-cell in lymphoma and leukaemia
- Rituximab is monoclonal antibody binds to CD-20 cell surface molecule
MAC signalling calls upon cytotoxic T-cell release via Fc*y- receptor binding or induces phagocytosis via same receptor route.

Question 7

Discuss treatments for multiple myeloma

Answer 7

• radiotherapy for localised bone pain
• chemotherapy
• immunotherapy = C-ART, IL-6 targets,