Treatment of blood cancers Flashcards
How does chemotherapy and radiotherapy kill cancer cells?
It damages the DNA of cancer cells as it divides
Cell recognises it is damaged beyond repair and dies by apoptosis
How does lower dose differ to higher dose of chemo?
Lower causes less side effects and apoptosis
Higher causes more side effects and necrosis of cell
Why do lymphoma and acute leukaemia respond better than most other to chemo and RT
Lymphocytes are more keen to undergo apoptosis in normal lymph node
Acute leukaemia is dividing so quickly that more cells are affected by the chemo
S/E of chemo and radiotherapy?
Hair loss, nausea and vom, neutropenic infection
Tiredness due to wide spread cell damage
Other cancers
Heart damage
Lung damage
Antifungal prophylactics?
Itraconazole
Posaconazole
Features of monoclonal antibodies?
Affect only cells which possess target protein
Avoid side effects
Not replacement for chemo–> combo
Anti B cell antibodies?
Rituximab
Ofatumunab
Features of biological treatments?
Not targeted to malignant cells-S/E
Don’t affect cells as they divide
Proteosome inhib and IMID
How do proteosome inhibitors work?
Proteosome is dustbin for old proteins inside cells
Breaks them down to amino acids
Blocking this allows build up of toxic proteins causing apoptosis
What are IMIDs?
Derivative of thalidomide e.g. lenolidoide
Side effects of nerve damage?
Risk of damage to fetus
Effect on blood counts
Other cancers
Genetic cause of CML?
Translocation between chromosomes 9 and 22 creating new BCR-ABL gene
Examples of tyrosine kinase inhibitors?
Imatinib
Nilotinib
Drugs affecting B cell signalling pathways?
Ibrutinib (GI Upset)
Effective in low grade NHL and B cell CLL that dont respond to rituximab and chemo
Examples of checkpoint inhibitors?
Nivolumab in malignant melanoma, Hodgkins and lymphoma
