Malignant Lymphomas Flashcards
What are the two types of malignant lymphomas
Hodgkin’s and Non Hodgkin’s Lymphoma
List 8 aetiologic agents that can cause Malignant Lymphoma
Environmental agents(herbicides, wood dust, glues, fertilizers)
Genetic abnormalities
Inflammatory bowel disease
Autoimmune disorders
Lymphatoid papulosis
Immunodeficiency states
Viral Infections
Bacterial Infections
Which bacterial infections can lead to development of malignant lymphoma
Helicobacter pylori
Campylobacter jejuni
What age is most at risk with Non Hodgkin’s lymphoma
Increases with age
Which gender is more prone to Non Hodgkin’s Lymphoma
Male
List 7 clinical features of Non Hodgkin’s lymphoma
Painless lymph node enlargement
Hepatosplenomegaly
GI symptoms
Features related to disease at extranodal sites
Constitutional symptoms- fever, night sweats, weight loss
Cytopaenias
Metabolic Derangements
What tests are used to diagnose Non Hodgkin’s lymohoma
Tissue biopsy Functional imaging (PET) scan
What investigations are done when testing for Non Hodgkin’s lymphoma
History and physical exam CBC Serum chemistry Radiology BM aspirate and biopsy Lumbar Puncture with CSF in selected cases GI endoscopy Cytology of third space fluids Selected additional radiology Lymph Node Biopsy Molecular Markers Cytogenetic
What are five classification of prognosis factors for Non Hodgkin’s lymphoma
Molecular profiling using gene expression
International Prognostic Index (IPI) for aggressive NHL/ FLIPI Score (follicular Lymphomas)
Biology
Laboratory
Clinical
What clinical factors are used for prognosis of NHL
Stage Age Performance status B symptoms Mass size Number of extra nodal sites BM involvement Time to Complete Remission (CR)
What are the characteristics for International Prognostic Index (IPI) for aggressive NHL
Age > 60 Stage (III or IV) LDH - elevated No of extranodal status (2-4) Performance status (2-4) Max score of 5
What are the characteristics for International Prognostic Index (IPI) for aggressive NHL
Age Stage >4 LN groups involved LDH Performance Status Hb <12gm/dl
What is the classification of Low Grade Lymphoma
Small lymphocytic Lymphoma
Follicular small cleaved cell
Follicular mixed lymphoma
How is Low grade lymphoma treated
Chemotherapy
Monoclonal Ab
Maintenance therapy
How is Intermediate grade lymphoma treated
Chemotherapy +/- monoclonal Ab therapy if indicated
Combined modality therapy (never Radiotherapy alone)
What is the treatment given for High grade lymphoma
Combination therapy
What is the treatment for Relapsed NHL
Autologous stem cell transplantation in pts with chemo sensitive disease
List 9 Special Lymphomas
ATLL- Adult T cell Leukemia/Lymphoma HTLVI associated Peripheral T cell NHL Lymphadenopathy Hepatosplenomegaly Lytic bone lesions Leukemia Cutaneous Lymphoma Hypercalcaemia
List five types of ATLL (Adult T cell Leukemia/Lymphoma)
Smouldering Chronic Lymphoma Acute Defined by LDH level
What is the pathogenesis of Non Hodgkin’s lymphoma
HTLV1 (human T cell leukemia virus type 1)
Mother to child - breastfeeding
(IV drug use)
(Male to female )
What is the general treatment for Non Hodgkin’s lymphoma
Correct hypercalcemia
Allopurinol to avoid hyperuricaemia
Manage infections
Which cell is involved in Lymphoblastic Lymphoma
T cell
How is lymphoblastic lymphoma treated
Prophylactic treatment for CNS
Treated as ALL
Which cell is involved in HIV associated NHL
B cell
