Oncology Flashcards
What is B cell ALL standard risk?
Age 1-10 and WCC <50 at presentation
All others are high risk
Is hyperdiploid (more chromosome in malignant cells) good or bad?
It is good - having more than 50 chromosomes is protective
However T21 is bad!
What translocations in ALL are bad?
t9: 22 (robertsonian)
4: 11 translocation KMT2a (MLL)
What translocation in ALL are good?
t(12:21) ; TEL/AML1 or ETV6 -RUNX1
What is the cure rate for all leukaemia?
90%
Standard risk - 92%
Fusion of BCR (from chromosome 22) and ABL1 (from chromosome 9) creates abnormality in which protein?
Tyrosine Kinase
What tyrosine kinase inhibitors are used alongside?
Imatanib and Dasatinib
What does Auer rod mean?
AML !
What does a Reed Sternberg cell mean and describe it
Owl eye appearance - big cell with two part and two distinct nuclei
Hodgkins lymphoma
How does Blinatumomab work?
Cd3 and Cd19 combo - CD 19 binds to B cell and atracts T cell to kill the bad B cell
What is CAR-T cell therapy?
These are engineered or autologous chimeric antigen receptor T-cells to target specific cells
What is Brentuximab and what is it used to treat?
CD30 antibody -> leads to cell apoptosis
Used to treat Hodgkin and ALCL
What is Gemtuzumab?
It targets CD33 and used against AML
Haematopoetic stem cell is characterised by CD __
CD34 expression
What is the ideal source for HSCT?
1) Matched
2) Marrow
3) Sibling
If mismatched - preference for mismatched family donor -marrow or
Mismatched cord blood
be mindful that in large kids (>50kg) may not get enough from cord
_______ donor is better for metabolic disorders
Unrelated cord blood
Which chemo agents can predispose for VOD?
Busulphan
Gemtuzumab
Von Hippel–Lindau (autosomal dominant) is associated with which sort of brain tumours?
Haemangioblastoma
What are Rosenthal fibers and what are they associated with?
They are condensed masses of glial filaments occurring in compact areas with low mitotic potentials helps establish the diagnosis of pilocytic astrocytomas
Chemotherapy agents given singly or in combination for _____ include carboplatin, vincristine, lomustine, procarbazine, temozolomide, and vinblastine
Low grade astrocytomas
Astrocytomas associated with tuberous sclerosis have responded to _________
Everolimus - mammalian target of rapamycin inhibitor
Oligodendrogliomas consist of __________ (histology). Observation of a __________ (radiology) on CT in a patient presenting with a seizure is suggestive of oligodendroglioma
Histology - rounded cells with little cytoplasm and microcalcifications
Radiological findings - calcified cortical mass
What is the most common brain tumour in children <1yr
Choriod plexus tumours
Choriod plexus tumours are commonly associated with ______
Li Fraumeni syndrome
Neuronal differentiation is more common among Medulloblastoma and is characterized histologically by the presence of _________________
Homer Wright rosettes and immunopositivity for synaptophysin.
The most common abnormality in medulloblastoma involves _____________, which occur in 30–40% of all cases
Chromosome 17p deletions
________ are collections of myeloid leukemia cells and can occur throughout the neuraxis
Chloromas
Most common brain tumour to metastasize?
Medulloblastoma
bHCG is 100% positive in
Choriocarcinomas
What is the mechanism of action of Allopurinol and what complications can occur?
Allopurinol is a Xanthine Oxidase inhibitor - it inadvertently alkalises the urine and can precipitate Calcium phosphate stones
How does Rasburicase work?
It is a urate oxidaser and converts uric acid into allatoin which is more water soluble
What are the three cardinal electrolyte abnormalities with TLS?
HypoCa, HyperK+, HyperPO4
Name 8 common live vaccines?
BCG (bacille Calmette–Guérin) vaccine Japanese encephalitis vaccine MMR (measles-mumps-rubella) vaccine rotavirus vaccine oral typhoid vaccine varicella vaccine yellow fever vaccine zoster vaccine
Diagnostic criteria for MDS include cytopoenia in 1 or more lineage (most commonly erythrocytes), dysplastic cells on film and ______ blasts in blood and bone marrow.
<20% blasts -> if more, it is AML
Osteosarcoma occurs in teenage boys but is associated with a ________ on x-ray.
Sunburst lesion
Onion peel or moth eaten appearance is associated with ________
Ewings Sarcoma
Name three Ribonucloetide reductase inhibitors and their mechanism of action?
Hydroxyurea - blocks RRI by binding to iron molecule
Fludarabine/Gemcitabine - blocks RRI and DNA polymerase
Name two topoisomerase inhibitors and their mechanism of action?
Irinotecan/topotecan - inhibit topoisomerase I
Etoposide/Teniposide - inhibit topoisomerase II
What are three antitumour antiobiotics and how do they work?
Bleomycin - binds to DNA, produces free O2 and oxidase DNA bases
Dactinomycin - intercalates DNA bases, prevents replication
Anthracyclines - intercalates DNA, inhibit Topoisemerase II and produce free O2 radicals
_________ can prevent cardiotoxicity from Anthracyclines
Dexrazoxane