Marginal zone lymphoma

Question 1

MZL immunophenotype + MYD88 status

Answer 1

CD20+
*CD5-
CD10-
Negative for MYD88
Cyclin D1 negative

Question 2

Translocation that predicts for resistance to H pylori eradication in MZL

Answer 2

t(11;18)

Question 3

Response assessment for MALT lymphoma after h pylori treatment

Answer 3

***Wait at least 3 months after treatment to assess response (responses can be slow)
Repeat endoscopy w/ biopsy in 3 months

Question 4

Next step after endoscopy for MALT lymphoma after h pylori treatment

Answer 4

IF HP neg + MZL negative, observe
IF HP neg + MZL positive,
IF asymptomatic, observe
If symptomatic, XRT
IF HP pos + MZL negative, 2nd line abx
IF HP pos + MZL pos, 2nd line abx +/- XRT

Question 5

Splenic MZL management

Answer 5

Watch and wait for most patients (indolent lymphoma management)
IF indication for treatment
BR
Single agent rituxan
Splenectomy w/ pre-op vaccinations

Question 6

second line for marginal zone

Answer 6

Zanubrutinib

Question 7

clinical behavior of mantle cell lymphoma

Answer 7

Aggressive in vast majority of cases

Question 8

MCL immunophenotype

Answer 8

• Cyclin D1+
  *CD5+
  CD23-

Question 9

MCL and SOX11 clinical significance

Answer 9

Aggressive variant tends to be SOX11 positive

Question 10

MCL management

Answer 10

• convention (and likely board answer) was intensive chemo induction with auto-transplant
• now with BTKI inhibitors and TRIANGLE, there is a question of whether auto-HSCT is needed

Question 11

Second line for MCL

Answer 11

Second generation BTK inhibitors
*CAR-T also approved now