Set A > Lymphoma > Flashcards

Lymphoma Flashcards

(50 cards)

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1
Q

Blood stem cells from red bone marrow can give rise to which 2 types of stem cells

A

Myeloid stem cells
Lymphoid stem cells

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2
Q

Myeloid and Lymphoid stem cells give rise to

A

Red blood cells
White blood cells
Platelets

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3
Q

What is lymphoma?

A

Cancer of the lymphatic system

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4
Q

What are 4 classes of NHL

A

Aggressive B-cell lymphoma
Aggressive T-cell lymphoma
Indolent B-cell lymphoma
Indolent T-cell lymphoma

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5
Q

Give the main example of an aggressive B cell lymphoma

A

Diffuse large B-cell lymphoma
(DLBCL)

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6
Q

Give the main example of an indolent B-cell lymphoma

A

Follicular lymphoma

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7
Q

Symptoms of NHL

A

Night sweats
Weight loss
Fatigue
Fever

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8
Q

Name 2 physical exams you could do for NHL

A

Splenomegaly
Lymphadenopathy

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9
Q

Describe stage 1 NHL

A

Single lymph node group

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10
Q

Describe stage 2 NHL

A

Multiple lymph node groups on the same side of the diaphragm

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11
Q

Describe stage 3 NHL

A

Multiple lymph node groups on both sides of the diaphragm

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12
Q

Describe stage 4 NHL

A

Multiple extranodal sites or lymph nodes and extranodal disease

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13
Q

What kind of cell does HL arise from?

A

Mature B cells

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14
Q

What is HL characterised by?

A

The presence of the Hodgkin/Reed-Sternberg cell

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15
Q

Name 3 risk factors of HL

A

Age 20-34 or >50
History of EBV
Jewish ancestry

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16
Q

Symptoms of HL

A

Same as NHL + dyspnea + cough

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17
Q

What physical exam could you do for HL?

A

Lymphadenopathy

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18
Q

Describe Stage 1 HL

A

Involvement of one lymph node or group of adjacent nodes
or
involvement of single extranodal lesions without nodal involvement

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19
Q

Describe Stage 2 HL

A

Involvement of 2 or more nodal groups on the same side of the diaphragm
or
Stage I or II nodal extent with limited contiguous extranodal involvement

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20
Q

Describe Stage III HL

A

Involvement of lymph node on both sides of the diaphragm

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21
Q

Describe Stage IV HL

Study These Flashcards
A

Involvement of additional non-contiguous
or
proximal to known nodal site

22
Q

MOA of Rituximab

Study These Flashcards
A

Binds to CD20 antigen on B cells and induces cell death via apoptosis

CD20 are found on normal and malignant B cells but not on haematopoeitic stem cells

23
Q

Monitoring requirements of infusion of Rituximab

Study These Flashcards
A

1st infusion: monitor for at least 6 hours
Subsequent infusions: monitor for at least 2 hours
Must have facilities to treat anaphylaxis
Monitor for infusion reactions including hypotension, wheezing, rash, flushing, pruritis, sneezing, cough, fever or faintness
If mild: reduce rate of infusion
If severe: stop infusion

24
Q

Which medications should you take during treatment with Rituximab

Study These Flashcards
A

Usually premedication includes:
- Paracetamol 1g
- Chlorphenamine 10mg
- Prednisolone 100mg
Should use contraception if woman of child bearing age during treatment and for up to 12-18 months afterwards

25
Which medication should you NOT take during treatment with Rituximab
Consider withholding anti-hypertensives for 12 hours before and after administration Do not receive live vaccines
26
MOA of Brentuximab vedotin
- Antibody binds to CD30 (present on tumour cells). - Internalised to lysosome - Antibody drug conjugate releases MMAE - MMAE is a microtubule inhibitor which leads to apoptosis
27
What does MMAE stand for?
Monomethyl auristatin E
28
Requirements for infusion of Brentuximab vedotin
Facilities to treat anaphylaxis Women of child bearing age should use contraception during treatment + for up to 6 months after treatment
29
List the 5 main adverse effects associated with Brentuximab vedotin
Pancreatitis Pulmonary toxicity Tumour lysis syndrome Peripheral neuropathy Blood disorders
30
What is contraindicated with Brentuximab vedotin and why?
Bleomycin Pulmonary toxicity
31
What drugs are included in CHOP-21 (21 meaning 21 days)
Cyclophosphamide Doxorubicin (Adriamycin) Vincristine (Oncovin) Prednisolone
32
Particular considerations with Doxorubicin
Moderate emetogenic potential Has a lifetime maximum dose (450-550mg/m2)
33
Particular considerations with Vincristine
It is neurotoxic. Prevent accidental intrathecal administration Give laxative to prevent vincristine - induced constipation
34
3 ways to prevent intrathecal administration of Vincristine
- Never administer on the same day as an intrathecal drug - 'Warning - neurotoxic drug' labels - Different colours of labels, packaging and transport bags
35
Particular considerations for Cyclophosphamide
Moderate emetogenic potential Increase fluid intake to prevent cyclophosphamide induced haemorrhagic cystitis
36
Which 2 drugs have moderate emetogenic potential in CHOP-21
Cyclophosphamide Doxorubicin
37
Which 3 things should you do to minimise ADRs of CHOP-21
PPI to prevent prednisolone induced acid secretion Laxative to prevent vincristine induced constipation Increased fluid intake to prevent cyclophosphamide induced haemorrhagic cystitis
38
Which 2 antimicrobial agents could you take during treatment with CHOP-21
Acyclovir 400mg BD PO Co-trimoxazole 960mg Mon, Wed, Fri to prevent pneumonia
39
What drugs are included in EPOCH/CHOEP
Etopside Prednisolone Vincristine Cyclophosphamide Doxorubicine
40
List 5 adverse effects of CHOP-21
Neutropenia Constipation Peripheral neuropathy Cardiotoxicity Risk of tissue necrosis from extravasation due to vincristine and doxorubicin
41
List 6 adverse effects of EPOCH
Neutropenia Constipation Peripheral neuropathy Cardiotoxicity Risk of tissue necrosis from extravasation due to vincristine and doxorubicin Infusion reactions with etopside
42
List the drugs in BEACOPP
Bleomycin Etopside Doxorubicin Cyclophosphamide Vincristine Prednisolone Procarbazine
43
Which 2 drugs in BEACOPP have lifetime maximum doses?
Bleomycin Doxorubicin
44
Which 3 drugs in BEACOPP have emetogenic potential
Procarbazine (moderate - high) Both cyclophosphamide and doxorubicin have mod.
45
Particular cautions with Procarbazine
Weak MOA inhibitor so caution with SSRIs, sympathomimetic use and tyramine rich foods May cause disulfiram like reaction
46
List the drugs in ABVD
Doxorubicin Bleomycin VinBLAStine Dacarbazine
47
Which 2 drugs in ABVD have emetogenic potential
Dacarbazine has high Cyclophosphamide has moderate
48
Which additional drug should be taken with ABVD regimen that is not required with others?
Allopurinol 100mg/m2 TDS to prevent tumour lysis syndrome
49
Could G-CSF be used for the treatment of neutropenia induced by ABVD?
No as it may precipitate bleomycin lung toxicity
50
What drug is contraindicated with Dacarbazine
Phenytoin - increased risk of convulsions
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