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21 Cards in this Set
- Front
- Back
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How is Hodgkins treatment divided? (3)
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1.) early stage: favorable
2.) early stage: unfavorable 3.) advanced stage (3-4) |
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What is unfavorable?
a.) ESR (2) b.) disease size c.) # d.) age |
a.) ESR >50 or ESR <30 + b symptoms
b.) bulky disease c.) > 4 sites of disease d.) >50 |
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Hodgkins treatment
a.) surgery? b.) radiation? c.) chemo? |
a.) NO! no place for surgery
b.) yes! combo radiation + chemo c.) yes! combo radiation + chemo |
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Types of radiation (3)
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1.) involved-site: original sites only
2.) involved-field: lymph nodes only 3.) extensive-field: lymph + adjacent + uninvolved lymph |
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Hodgkins lymphoma: favorable early stage
a.) 1st line (and abbreviation meaning) b.) ADR c.) how to decrease these ADRs? |
a.) ABVD (doxorubicin, Bleomycin, Vinblastine, Dacarbazine) plus ISRT
b.) cardiotoxicity, pulmonary toxicity c.) decrease IFRT dose (20), decrease # cycles (2) |
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Hodgkins lymphoma: unfavorable, early stage
a.) 1st line b.) alternatives (2) |
a.) ABVD (4-6 cycles) + ISRT
b.) escalated BEACOPP + RT or Stanford V + ISRT |
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BEACOPP
a.) place in therapy b.) abbreviation |
a.) advanced IPI >4: Hodgkins
Bleomycin Etoposide A - doxorubicin Cyclophosphamide O - vincristine Procarbazine Prednisone |
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Stanford V
a.) place in therapy b.) abbreviation |
a.) all stages; advanced <3 IPI: Hodgkins
BEAVOP-M Bleomycin Etoposide Doxorubicin Vinblastine Vincristine Prednisone Mechlorethamine |
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Hodgkins: Advanced (stage 3-4)
a.) first line |
a.) ABVD. not really ISRT unless there is bulk
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Hodgkins: Advanced, IPI <3
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a.) Standford V; ISRT prn
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Hodgkins: Advanced, IPI >4
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BEACOPP; ISRT prn
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Doxorubicin
a.) adr b.) MOA c.) monitoring |
a.) cardiotoxicity
b.) topo II inhibitor c.) ejection fraction at baseline |
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Bleomycin
a.) adr b.) MOA c.) monitoring |
a.) lung toxicity
b.) single & double DNA strand breaks c.) PFTs q2cycles |
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Vinblastine
a.) adr (2) b.) MOA c.) monitoring |
a.) peripheral neuropathy, myelosuppression
b.) antimitotic c.) ADLs |
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Dacarbazine
a.) adr (2) b.) MOA c.) monitoring |
a.) N/V, myelosuppression
b.) alkylating agent, single strand break c.) symptom relief |
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Relapse
a.) < 1 year after therapy initiation b.) >1 year after therapy initiation |
a.) diff regimen, stem cell transplant
b.) repeat same regimen |
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Refractory
a.) plan |
a.) diff regimen, stem cell transplant
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Relapse after tranplant
a.) drug |
a.) brentuximab
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Brentuximab
a.) indication b.) MOA |
a.) treatment after stem cell transplant due to relapse)
b.) CD30 ADC (antibody-drug conjugate) |
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Follow-up after Hodgkins treatment (3)
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1.) oncologist follow-up for 5 years - risk of secondary malignancy! bc of RT
2.) flu vaccine yearly (especially those with bleomycin treatment & chest RT) 3.) pneumococcal every 5 years |
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Endocrine disease that may come up
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hypothyroidism, so do annual thyroid exams
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