NHL Flashcards
Indications to treat follicular lymphoma stage III or IV?
- clinical trial
- symptoms
- end organ damage imminent
- cytopenia that are 5. significant or progressing
- bulky disease
- rapid progression
Is auto HSCT an option in 1st remission for follicular lymphoma?
no
In FL, what treatment would you use if pt was given 1L rituxan and had remission for >6mo?
retreatment with rituxan
how do you treat grade 3b FL (defined as >15 centroblasts with solid sheets of centroblasts)
as DLBCL; RCHOP
Maintenance therapy for FL for pts who present with high tumor burden?
Rituximab q2-3mo for 2 years
Tx for R/R FL that targets EZH2?
tazemetostat (methyltransferase inh)
MALT lymphoma that is H. pylori positive that carry this mutation are resistant to H. pylori -directed ABx.
t(11;18). need to add ISRT
Splenic MZL is associated with which virus?
Hep C
SMZL immunophenotype?
CD20+, CD22+, negative for CD5, CD10 and cyclin D1. lacks CD25 and CD103 which are positive in hairy cell leuk
Tx SMZL?
splenectomy or Rituxan. treat Hep C if positive as this may cause lymphoma to regress
low intensity regimens for mantle cell lymphoma?
BR
R-CHOP
VR-CAP
R2
BR + Cytarabine
ibrutunib dose in mantle cell lymphoma?
560mg PO daily
Aggressive treatment regimen for mantle cell should include?
cytarabine
high risk scenarios for CNS relapse in DLBCL?
- high CNS IPI score
- testicular lymphoma
- double or triple hit
primary cutaneous DLBCL, leg type - stage IE DLBCL of breast
- kidney or adrenal involvement
Treatment approach for nasal NK/T-cell lymphomas?
chemo RT. all regimens contain asparaginase
virus associated with PEL?
HHV-8
PEL affects which body cavities? Tx?
pleural, pericardium and peritoneum; R-EPOCH
+S100, +CD163, +CD68
CD1a- ; CD207-
Rosai Dorfman Disease
Tx for Rosai Dorfman Disease? localized disease?
First observe as 80% spontaneously improve; surgery; multifocal disease treated with COBIMETINIB, cladribine, cytarabine, MTX, or prednisone
treatment approach for T-PLL? (T-prolymphocytic leuk)
alemtuzumab-based therapy
breast-implant associated lymphoma?
anaplastic large-cell lymphoma (7-9 years after implant)
Do plasmablastic lymphomas express CD20? Virus association?
No; HIV – treat with EPOCH and IT chemo
preferred tx for ALCL ALK+? Second line?
BV-CHP; alectinib or crizotinib
Ppx needed for polatuzumab?
PCP and herpes ppx
Immunohistochemical signature of Primary Mediastinal BCL?
Positive for B-cell markers (CD19, 20, 22, 79a), CD45, CD200, CD23, and MAL
Neg for CD5 and CD10.
Define bulky disease in DLBCL?
lymph node mass > 7.5cm
Tx limited stage (I or II) non-bulky DLBCL?
RCHOP x3 +RT
or
RCHOP x4
Tx limited stage (I or II) bulky DLBCL?
RCHOP x6 +/- RT
Do you give maintenance in Burkitt’s lymphoma? CNS ppx?
No; yes
Castleman’s disease aka giant lymph node hyperplasia is defined as active when:
- fever
- increase serum CRP >20
- 3 of the following symptoms: LAD, large spleen, edema, effusion, ascites, cough, nasal obstruction, xerostomia, rash, central neurologic symptoms, jaundice, AIHA
Treatment for pulmonary lymphomatoid granulomatosis (PLG)?
Asymptomatic: withdraw implicated medication (azathioprine, methotraxate, etc) and observe
Symptomatic: RCHOP
Tx backbone for T-PLL (t-cell prolymphocytic leukemia)?
Alemtuzumab ((binds CD52)
compare IHC of Mantle cell vs CLL/SLL vs FL?
Mantle and CLL both CD5 positive but CLL typically CD23+ and C20+ while Mantle typically CD23-. Mantle is FMC7+ while CLL is FMC7-.
FL is CD10+
MALT lymphoma of skin assoc with which bug?
borrelia burgdorferi
Most common marker that represents indolent mantle cell lymphoma?
SOX11 neg / IGHV mutated
