Newman: Leukemia and Lymphoma

Question 1

What is the leading cause of death by disease past infancy among children in the United States?

Answer 1

Cancer

Question 2

What is the most common types of cancer diagnosed in chidlren ages 0-14 y/o in the US?

Answer 2

Leukemias (ALL)

Question 3

MC cancer in adolescents vs in younger children

Answer 3

Younger children = leukemia

Adolescents = lymphoma

Question 4

Which type of lymphoma is the most common malignancy in age group 15-19 y/o? often assx with?

Answer 4

Hodgkin lymphoma; EBV

Question 5

What are B-symptoms?

Answer 5

1. Unexplained fever 39°C
2. WL >10% total BW over 6 months
3. Drenching night sweats

Question 7

Any pt with persistent, unexplained LAD NOT assx with an obvious underlying inflammatory or infectious process should get what?

Answer 7

CXR to rule of mediastinal mass before undergoing LN biopsy

Question 8

What are the clinical manifestations of Wiscott-Aldrich Syndrome; how is it inherited; what is it a risk factor for?

Answer 8

- X-linked recessive

1. Recurrent sino-pulmonary and ear infections
2. Severe atopic dermatitis
3. Bleeding –> 2’ to significant thrombocytopenia

• Risk factor for NHL***

Question 9

Burkitt lymphoma commonly manifests in pediatric populations how?

Answer 9

Abdominal (sporadic type)

or

• Head and neck dz (endemic type) w/ involvement of BM or CNS

Question 10

What is the prognosis of NHL?

what does survival depend on?

Answer 10

• Localized disease = 90-100% chance of survival
• Advanced = 60-95%

Survival depends on

• 1. Pathologic subtype
• 2. Tumor burdern at diagnosis reflected by LDH levels
• 3. +/- of CNS disease
• 4. Specific sites of metastatic spread

Question 11

Which type of leukemia constitutes 97% of all childhood leukemias?

Answer 11

Acute leukemia

Question 12

Which genetic trisomy associated with both ALL and AML?

Answer 12

Trisomy 21