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22 Cards in this Set
- Front
- Back
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cytogenic abnormality in 95-100% patients with CML
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BCR-ABL gene fusion
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hallmark of CML
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leukocytosis- usually > 25k. WBCs may range 100k-300k.
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syndrome in pts with WBC > 100k
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leukostasis. Infiltration of WBCs into tissue beds of major organs causing inability to function normally, esp lungs and CNS
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chronic phase CML=
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increasing WBCs and splenomegaly, blasts < 10%
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accelerated phase CML=
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10-19% blasts in PB or marrow, thrombocytopenia, thrombocytosis, peripheral basophilia >20%, increasing spleen size and WBC despit drug tx, or bone marrow evidence of progression
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CML blast crisis=
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>20% blasts in PB or BM, extramedullary disease, or large clusters of blasts in BM
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only curative therapy for CML
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allo HSCT
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hydroxyurea dose in CML
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1-5gm QD, adjusted as WBC decreases. DC when WBC <5
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cornerstone drug in CML
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imatinib
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imatinib dose
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400mg PO QD
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TKI used when imatinib fails
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dasatinib 100mg PO QD
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3rd line TKI for CML
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nilotinib 400mg PO BID
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CLL=
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defective apoptosis --> accumulation of lymphocytes in lymph nodes and spleen
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CR in CLL=
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normal Hgb, neutrophil, platelets and lymphocytes <4000/uL and BM infiltration < 30% lymphocytes
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most active chemo agent in CLL
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fludarabine
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alemtuzumab dose escalation
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3mg - 10mg - 30mg TIW
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alemtuzumab premeds
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APAP 650mg + diphenhydramine 50mg
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alemtuzumab adjunctive meds for PCP and HSV
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SMX/TMP DS TIW and famcyclovir 250mg BID
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MDS typical azacitidine dose
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75mg/m2/d SQ/IV x 7 days
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MDS typical decitibine dose
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15mg/m2 IV Q8h x 3 days
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use lenolidamide in MDS when
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chromosome 5 deletion
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lenalidomide dose in MDS
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10mg-25mg QD (or 21 of 28days)
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