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Haematology > New advances in Treatment for blood cancers > Flashcards

New advances in Treatment for blood cancers Flashcards

1
Q

How does chemo work?

A

damages DNA of cancer cells in mitosis causing cell to undergo apoptosis

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2
Q

what protein is usually invovled in apoptosis?

A

p53

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3
Q

Why do lymphomas and leukaemias respond better to chemo than other cancers?

A

lymphocytes are keen to undergo apoptosis in the normal lymph node

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4
Q

What is a PET scan?

A

in ject radio-labelled glucose and then through the gamma camera

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5
Q

How do monoclonal antibodies work?

A

immune treatment that affects only cells which possess target protein

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6
Q

What si the action of rituximab?

A

naked antibody that binds to CD20 on B cells- found on all B cell lymphomas

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7
Q

What is the problem with rituximab?

A

relies on bodys immune system to kill malignant cells once tagged

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8
Q

How does Brentiuximab Vedotin work?

A

chemo drug conjugated to CD30 antibody

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9
Q

CD30 is found on what type of lymphomas?

A

Hodgkins cells and some T cell NHL

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10
Q

What is bioogical treatments?

A

dont affect cells as they divide- not chemo and arent targeted to malignant cells

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11
Q

What are examples of biological treatments?

A

proteosome inhibitors and IMIDs

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12
Q

What haem malignancy are biological treatments mainly used in?

A

multiple myleom

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13
Q

What is the proteosome?

A

dustbin for old proteins in cells to recycle amino acids

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14
Q

What does blockade of the proteosome cause?

A

accumulation of toxic proteins inside the cell causing apoptosis

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15
Q

What are the main SE of proteosome inhibitors?

A

nerve damage and low platelets

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16
Q

What are IMIDs derivatives of?

A

thalildomide

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17
Q

What type of cancer are tyrosine kinase inhibitors used in?

A

chronic myeloid leukaemia

18
Q

What are the phases of untreated chronic myeloid leukaemia?

A

chronic phase (lots of immaure white cells in blood)—acclerated phase—blast crisis(transformed to acute leukaemia)

19
Q

What is the cause of chronic myeloid leukaemia?

A

chromosomal translcation T(9:22) which creates a new oncogene

20
Q

what is the name of the chromosomal translcation T(9:22)

A

philidelphia

21
Q

What is the name of hte oncogene created by the philidelphia chromosome?

A

BCR-ABL

22
Q

What is the normal function of a tyrosine kinase enzyme?

A

switches on proteins by phosphorylation

23
Q

What drug targets the tyrosine kinase action of BCR-ABL?

A

imatinib by taking place of ATP in BCR-ABL molecule

24
Q

What are the SE of tyrosine kinase inhibitors?

A

diarrhoea; fluid in lung; neutropenia

25
Q

What happens in B cell receptors dont receive stimulation by antigen?

A

undergo apoptosis

26
Q

What is the problem in CLL and lymphoma cells that causes them to avoid apoptosis?

A

abnormally active signalling mechanisms inside cell

27
Q

What are drugs affecting B cell signalling pathways?

A

ibrutinib; idelalisib

28
Q

When is idelalisib used?

A

CLL with p53 mutation- dont respond to chemo

29
Q

What are the side effects of ibrutinib?

A

fever; low platelets; anaemia; SOB

30
Q

What are the side effects of idelalisib?

A

diarrhoea; rash; fatigue; liver abnormality; fever

31
Q

What is the problem with the immune response in Hodgkins?

A

Reed Sternberg cells cause immune reaction, but cells are unable to kill the malignant cells: immune evasion

32
Q

How do Hodgkins cells avoid the immune system?

A

produce proteins that bind to PD1 receptors on T cells

33
Q

What is the purpose of PD1 receptors on T cells?

A

tells T cell that it is a host cell and not to kill

34
Q

What is the MOA of nivolumab?

A

sticks to the chemical produced by the cancer cell and stops it binding to the effector cell allowing attack of the cancer cell

35
Q

What type of agen in nivolumab?

A

checkpointi nhibitor

36
Q

What type of therapy is allogenic bone marrow transplant?

A

immune therapy

37
Q

Why is bone marrow transplant an immune therapy?

A

T cell from donor are also given to attack the cancer cells : gradt vs leukaemia or lymphoma

38
Q

What is the problem with graft vs leukaemia/lymphoma?

A

also graft vs host disease

39
Q

What is adoptive immunotherapy?

A

make patients own immune cells recognise cancer as foreign and attack

40
Q

What is hte most promising development in adoptive immunotherapy?

A

CAR t cell therapy (chimeric antigen receptor T cells)

41
Q

How does CAR T cell therapy work?

A

use retroviruses to create cell surface receptor specific to eg CD19 to target cancer cell

Haematology (29 decks)

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