monoclonal antibodies

Question 1

antibody

Answer 1

protein reacts w virus/bacteria and some cx cells to mark them for removal

Question 2

can antibodies be made artificially in lab

Answer 2

yes

Question 3

what white blood cell makes antibodies

Answer 3

B-cell lymphocyte

Question 4

antigen

Answer 4

protein molecules from either foreign or host sources in response to antibody

Question 5

b cell

Answer 5

wbc type

Question 6

where is b cell made

Answer 6

bone marrow

Question 7

what does b cell do

Answer 7

fight infection

Question 8

CD20 antigen

Answer 8

specific protein found on malignant and normal b cells

Question 9

low grade lymphoma

Answer 9

lymphoma that grows slowly

Question 10

another name for low grade lymphoma

Answer 10

“indolent” lymphoma

Question 11

refractory

Answer 11

resistant to treatment

Question 12

toxicity

Answer 12

unwanted side effects of cx therpies like decr in blood cells, hair loss, nausea, vomiting

Question 13

monoclonal antibody

Answer 13

type of protein designed to target a specific antigen

Question 14

hodgkins is usually seen in what type of patients? where at? and treatable?

Answer 14

pediatrics, seen in chest, few subtypes, easier to treat

Question 15

non hodgkins is usually seen where? in who? treatability?

Answer 15

adults, usually outside of chest area (lymph nodes… colon), many subtypes, what we usually treat in PET

Question 16

whats zevalin

Answer 16

MoAb therapy with a Y90 isotope that is paired with chelator (tiuxetan) and anti-CD20 mAb (ibritumomab)

Question 17

zevalin=

Answer 17

MoAb+Y90

Question 18

indications for zevalin

Answer 18

previously untreated NHL in pt who achieve partial/ complete response to first line chemo
-relapsed/ refractory, low grade or follicular b cell NHL

Question 19

top 3 cancers for men

Answer 19

1-prostate
2-lung
3-colon

Question 20

top 3 cancers for women

Answer 20

1-breast
2-lung
3-colon

Question 21

zevalin is composed of three things

Answer 21

1-ibritumomab (MoAb)
2-tiuxetan (chelator) that covalently links to ibritumomab and tightly binds to Y-90
3-Y-90 (radioisotope) high energy beta emitter

Question 21

hama rxn is and how do we pretreat

Answer 21

human anti mouse antibody is an allergic rxn to mouse antibody. pretreat with tylenol and benadryl

Question 22

what does zevalin combine with in terms of how it works

Answer 22

combines targetting and therapeutic activity of MoAb with the cytotoxic activity of radiation

Question 23

what antigen does zevalin bind to and what cell expresses it

Answer 23

CD20 on b cell in NHL

Question 24

what does beta emission from y-90 do

Answer 24

induces cellular damage and formation of free radicals in target and neighboring cells and is known as cross fire effect

Question 25

why do we give rituximab

Answer 25

saturate readily available CD20 sites in spleen and normal b cells so that cx cells are to be main target of therapy

Question 26

what is zevalin indicated for

Answer 26

all low grade NHL

Question 27

types of low grade NHL

Answer 27

-small cell lymphoma -follicular lymphoma -mucosa-associated lymphoid tissue lymphoma -lymphoplasmacytic lymphoma -waldenstrom macroglobulinemia

Question 28

whats given day 1 of zevalin trtmnt

Answer 28

250mg/m^2 of rituximab in an OP facility or hem/onc office

Question 29

what is given on day 7,8, or 9

Answer 29

250 mg/m^2 of rituximab and followed within 4 hours with zevalin dose

Question 30

premedicated before what and how much

Answer 30

prior to rituximab infusion 650 mg Tylenol and 50 m g benadryl

Question 31

how long should iv infusion be given of zevalin

Answer 31

over 10 min

Question 32

dose for pt with normla platelet count

Answer 32

0.4mCi/kg

Question 33

dose for pt with platelet ct greater than or equal to 100,000-149,000 cells mm^3

Answer 33

0.3 mCi/kg in refractory or relapse

Question 34

lab criteria

Answer 34

pt w previously treated follicular NHL who achived PR or CR to first line chemo need to meet following: -platelet >=150,000 mm^3 -25% bone marrow involvement

Question 35

lab criteria n relapsed or refractory NHL

Answer 35

-platelet >= 100,000 mm^3 -25% bone marrow involvement

Question 36

shield ing used for zevalin

Answer 36

acrylic or acrylic combo

Question 37

whats the best shield material for pure beta

Answer 37

plastic or acrylic

Question 38

why does shileding with lead aka a high atomic number = no bueno

Answer 38

bremsstrahlung rad created

Question 39

y-90 t1/2 and energy

Answer 39

2.7 days and 2.3 MeV

Question 40

y90 travel length

Answer 40

5 mm

Question 41

y90 shield

Answer 41

acrylic

Question 42

is thryod protectin needd y90

Answer 42

no

Question 43

is isolation needed for y90

Answer 43

no

Question 44

i131 t1/2 and energy and length

Answer 44

8 days, 1 mm, 0.61 MeV

Question 45

what does i131 emit

Answer 45

beta and gamma

Question 46

gamma energy for i131

Answer 46

0.35 MeV

Question 47

is thyroid protection needed for i131

Answer 47

yes

Question 48

shiledin material for i131

Answer 48

lead

Question 49

isolation needed for i131?

Answer 49

yes

Question 50

what type of cx being treated with zevalin

Answer 50

NHL