prognosis Flashcards
agranulocytosis
Overwhelming infections can cause death within hours to days.
neutropenia
-Increased susceptibility to bacterial and fungal infections
Hemophagocytic Lymphohistocytosis (HLH)
Treated: 50% survive
—May have significant sequelae (renal damage: adults, mental retardation: children).
Untreated: grim prognosis, < 2 months survival if familial
ALL (acute lymphoblastic leukemia)
o Poor Prognosis if
“ Age < 2 (MLL translocation).
“ T(9:22) Philadelphia ch.
“ Presentation in adolescence or adulthood.
“ Peripheral blood blast count > 100,000 (high tumor burden likely).
“ Detection of residual disease after therapy.
o Favorable Prognosis if: " Age between 2 and 10 yo. " Low white cell count. " Hyperdiploidy.** 90% have this " Chromosome 4, 7, 10 trisomy. " Presence of t(12:21).
- leading cause of childhood death d/t cancer.
- 95% of children reach complete remission.
adults: Only 35-45% are cured d/t different molecular pathogenesis and inability to tolerate the necessary chemo regimen effective in children
Richter synd (from C/SLL (chronics,small lymphocytic leukemia))
under 1yr
C/SLL (chronics,small lymphocytic leukemia)
Median survival 4-6 yrs, 10 yrs in pts with Decreased tumor burden at diagnosis.
Poor Prognosis if:
- 11q, 17p deletions.
- Lack of somatic hypermutation.
- ZAP70 (+): augments Ig receptor signaling.
- NOTCH1 mutations.
- Richter syndrome.
burkitt lymphoma
- Responds well to chemotherapy.
- Children and young adults are usually cured.
- Older adults have more guarded outcome
follicular lymphoma
- waxing and waning course
- 7-9 yrs regardless tx
- progress DLBCL or burkitts –> 1 yr
DLBCL (diffuse large B cell lymphoma)
- rapidly fatal w/o tx
- Treated: 60-80% complete remission, 40-50% cured.
multiple myeloma (plasma cell myeloma)
Survival 4-7 yrs
If untx bone lesions: 6-12 mos
solitary myeloma (plasmocytoma)
Bone lesion in same locations as MM → multiple myeloma in 10-20 yrs even if it is resected.
Extraosseous lesions in lungs, oronasopharynx or nasal sinuses → cured by local resection. (not onto MM)
smoldering myeloma
75% progress (unpredictably) to multiple myeloma in 15 yrs.
-lymphoplasmacytic lymphoma
4 yrs
mantle cell lymphoma (MCL)
poor: 304 yrs
organ dysfunction d/t lack of effective chemo and tumor infiltration.
hairy cell leukemia
excellent
Peripheral T-cell Lymphoma, Unspecified
cure rare; worse prognosis than aggressive B cells
Anaplastic Large Cell Lymphoma
good prog: kid and alk
bad prod: adult and alk-
Adult T-cell Leukemia/Lymphoma
- Rapidly progressive disease, fatal in months to 1 yr despite aggressive chemo.
- If only skin is involved (rare), disease has a more indolent course
Mycosis Fungoides & Sezary Syndrome
8-9 yrs
Extranodal NK/T-cell Lymphoma
highly aggressive; poor in adv dis
Hodgkin Lymphoma: Nodular Sclerosis Subtype
Hodgkin Lymphoma: Mixed Cellularity Subtype
Hodgkin Lymphoma: Lymphocyte Rich Subtype
Hodgkin Lymphoma: Lymphocyte Depletion Subtype
Hodgkin Lymphoma: Lymphocyte predominant Subtype
- excellent: stage 1, 2
- adv stage, but good prog
- very good-excellent
- adv stage, bad prog
- excellent: stage 1, 2, but recur
AML w genetic abbr AML w MDS-like features AML therapy related AML, NOS Overall:
- AML w genetic abbr: favorable
- AML w MDS-like features: poor
- AML therapy related: very poor
- AML, NOS: intermediate
- overall: 60% remission with chemo, 5 yrs: 70-85% relapse.
Myelodysplastic syndromes (MDS)
- 9-29 survive
- Worse outcomes: higher blast counts, more severe cytopenias with multiple clonal chromo Abn
t-MDS
4.8 mos, high progression to AML
Chronic Myelogenous Leukemia (CML)
- worse if not have phl chromo, in blast crisis, accelerated phase
- w/o tx: 3 yrs
Polycythemia Vera (PCV or PV)
untx: death w/in mos
Essential Thrombocytosis (ET)
12-15 yr survival
-Multifocal Multisystem Langerhans Cell Histiocytosis (letterer-siwe Disease)
Untreated = rapidly fatal
5 yr survival: 50%
