Non Hodgkin Lymphoma and other B cell lymphomas

Question 1

Burkitt Lymphoma chromosomal translocation

Answer 1

chromosomal translocation t(8,14) and creates C myc oncogene

Question 2

Burkitt lymphoma associations

Answer 2

endemic in Africa
seen with EBV virus
presents with small bowel or jaw mass - if with jaw mass may not have the t(8,14) change

Question 3

follicular lymphoma chromosomal translocation

Answer 3

t(14,18) translocation

overproduction of bcl-2 and lymphocytes have apoptosis

see non cleaved lymphocytes on biopsy

Question 4

follicular lymphoma associations

Answer 4

seen in older adults with prior cancers.

Question 5

mantle cell chromosomal translocation

Answer 5

t(11,14) see overproduction of cyclin-D1

Question 6

mantle cell lymphoma associations

Answer 6

seen in older pts and involves GI disease

Question 7

Non Hodgkin lymphoma is

Answer 7

spreads hematologenously and need to get excision of lymph node NOT aspiration

Question 8

if relapsed non hodgkins lymhoma, repeat aggressive chemotherapy

Answer 8

then stem cell transplant.

Question 9

poor prognosis with NHL

Answer 9

age>60 yrs
serum LDH is high
PPS:<70
Ann Arbor staging 3 or 4
Hgb<12

Question 10

low grade NHL treatment (follicular small lymphocytes)

Answer 10

Lymph nodes positive, no symptoms can observe

if there’s aggressive transformation or bulky disease (or pleural effusions)
tx with rituximab or RCHOP

Question 11

intermediate grade NHL treatment is

Answer 11

follicular with large or small cell
diffuse
mixed

R-CHOP

Question 12

high grade NHL treatment is:

Answer 12

large cell, immunoblastic
small non cleaved cell

CHOP +/- rituximab + radiation
OR EPOCH + rituximab no radiation

THEN get a stem cell transplant