Lymphopoiesis Flashcards
light cahins can establish
clontality in b cells
symptoms of lymphoma
local enlargement; typically non-tender
compression of adjacent structures
release of cytokines, producing sytsemic B symptoms
b cell lymphoma of follicular origin
monoclonal light chain, CD 19, CD20, CD5 pos, CD 10 neg
b cell small lymphocytic lymphoma
monoclonal light chain, CD 19, CD20, CD5, CD 23 pos, CD 10 neg
indolent lymphmas
Follicular
Marginal Zone
MALT
intermediate lymphoma
diffuse large cell
peripheral t cell
highly aggressive lymphoma
burkitt
4 types of classical hodgkins lymphoma
nodular sclerosing
lymphocyte predominant
mixed cellularity
lymphocyte depleted
most cases of lyphoma are not
familial
fatigue is NOT
a b symptom
LDH is a sign of
cell turnover in NHL
Ann Arbor Staging System
Stage 1- single lymph node on one side of diaphragm
Stage 2- 2+ on same side of diaphragm
Stage 3- lymphs on both sides of diaphragm
Stage 4- diffuse involvement of extralymphatic sites
IPI
age >60 perf status (2-4- lower is better) LDH level- elevated extranodal involvement >1 site stage (III-IV)
diffuse large cell lymphoma stage 1/2 cure
chemo and radiation
diffuse cell treatment stage III/IV
chemo only
CHOP
cyclophosphamide
doxorubicin
vincristine
prednisone
follicular lymphoma
slow dividing lymphocytes–>disease of slow accumulation due to defect apoptosis
increase in regulated BCL2–>anti-apoptic cells
grade 1 follicular lymphoma
small cleaved lymphocytes
treatment of follicular lymphoma
watch and wait
treat for symptoms!
1/2a focciluclar
radiation only
2B/3 follicular lymphoma
gentle chemo
CHOP w/o anthracyclin
incurable
unless autologous stem cell or localized disease
Marginal zone lymphomas
nodal marginal zone lymphoma
extramarginal zone lymphoma (MALT)
mantle cell lymphoma
nodal marginal zone lymphoma
very similar presentation and course to follicular so treat like follicular
extramarginal zone lymphoma
hpyloti; treat up to a year
mantle cell lymphoma
aggressive; noncurable
t(11;14)–>cyclin D–>pushes cell through cell cycle
Burkitt lymphoma
from germinal center- trans of MYC ongene–>persistnat expression–>constant replication
treatment sporadic bburkitt cell lymphoma
intense, short,multi-agent chemo
biggest progonostic factor if Hodgkins Lymphoma
PET scan negative after 2 treatments
hodgkins lymphoma
generalized adenopathy-->cervical/axillary -above mediastinum mediastinal mass systemic symptoms -B -pruritis -alcohol-induced pain hepatosplenomegaly
nodular lymphocyte predom
neck; young pts
popcorn cell
classical hogdkins lymphoma
nodular sclerosis- most common
mixed cellularity- most aggressive- more RS, eosino, plasma, mono nuclear variant RS
lymphocyte rich
lymphocyte depleted- older patients, retroperitoneum, loss lympho, sclerosis, pleomorphic RS cell
cRABi
hypercalcemia renal insufficiency anemia bone marrow lesions infections
multiple myeloma where does cell come from
post germinal
cds for MM
cd38, cd138
IG with worse prognosis
iga
follicular markers
CD10
CD20
BCL2
t(14;18)
DLCL
CD20
BCL2
BCL6
Mantle cell
CD5
CD20
cyclin D1
t(11;14)
marginal markers
CD20
t(11;18)
c-myc
CLL/SLL markers
CD5
CD20
s/g dim CD23+
CML
t(9;22)
PV
Jak2
AML
t (18;21)
Inv 6
T(16;17)
poor prognosis AML
Del 5,7
complex CG
