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70 Cards in this Set
- Front
- Back
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lympoma originate from -- stem cells
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lymphohematopoietic stem cells
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lymphoma results from damage to the dna of a --- ---- which them becomes malignant and -- ----
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single cell
continuously |
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hodgkins based on --- cells
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reed-sternmberg
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nhl further classified based on -- features, -- and ---
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genetic
morphology immunophenotype |
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when do you treat nhl follicular
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when symptomatic
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aggressive nhl curability
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curable in some
treat |
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highly aggressive nhl curability
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curable in some
treat |
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only way to make a definate dx
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biopsy
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tx of hodgkins
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radiation
and chemotx |
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tx of nhl
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early: rt
widespead disease: chemotx |
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hodgkin's linked to --- --- virus
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epstein-barr virus
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s/sof hl
pain/painless rubbery swelling of LN persistent ----- recurrent high -- night --- -- - loss ---- lymphadenolpahty |
painless
fatigue fever night sweats itching weight loss mediatinal |
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risk for HD
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HIV
epstein barr virus organ transplant white males |
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adverse risk prognostic risk factors
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B symptoms
extranodal disease bulky disease 3 or more sites of nodal involvement esr rate >= 50 |
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primary tx for most pts w/ HD
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chemo
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how do you tx refractory/recurrent disease salvge tx
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chemo
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standard chemo for HD
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ABVD
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ABVD
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doxorubicin
bleomycin vinblastine dacarbazine |
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what's necessary w/ doxorubicin
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central line
cv baseline (echo, not ekg). . . cardiotoxicity |
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which has better outcomes: abvd or mopp
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abvd
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how do you tx refractory/recurrent disease salvge tx
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chemo
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standard chemo for HD
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ABVD
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ABVD
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doxorubicin
bleomycin vinblastine dacarbazine |
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what's necessary w/ doxorubicin
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central line
cv baseline (echo, not ekg). . . cardiotoxicity |
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which has better outcomes: abvd or mopp
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abvd
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bleomycin can cause -- toxicity
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pulmonary
so baseline pulm test needed any pulm s/s repeat test |
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vinblastine can cause --- toxicity
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neuro
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which is better at preserving ovarian/testicular fx
abvd/mopp/stanford v |
abvd
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abvd has less risk for secondary ---- vs mopp/beacopp
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malignancies
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cycles of abvd needed
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4-6
depending on stage of disease |
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abvd given days:
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1 and 15
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early stage favorable disease tx:
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2 cycles of stanford V
or 4 cycles of ABVD and radiation (consolidation: radiation) |
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tf
early stage favorable disease tx: radiation alone has a higher relapse rate |
t
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early stage unfavorable disease:
tx |
abvd x 4 cycles and involved field radiation
abvd x 6 cycles others: stanford 5 beacopp (more aggressive w/o proven superiority and more toxic) |
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advanced-stage disease
tumor location |
on both sides of diaphragm
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advanced stage
favorable tx |
abvd x 6-8 cycles for pt w/ favorable
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advanced stage
unfavorable tx |
beacopp
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long term complications:
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sterility
secondary ca cardiac dysfunction worse w/ chemo/rt |
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sterility dose related for
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alkylating agents
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sterility for men/women
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almost all men
50% of premenopausal women |
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s/s of nhl
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lymphadenopathy
fatigue b symptoms |
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lymphadenopahty causes
-- symptoms may -- and --- may grow ----- may cause --- --- if large |
localized symptoms
wax and wane aggressively organ dysfunction |
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b symptoms
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fever
night sweats (drenching) weight loss |
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risk factors for nhl
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immunodeficiency states
autoimmune disease viral/bacterial increased age family hx males chem/drug exposure |
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faithful, loyal
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treu
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when is immunotx used alone
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maintenance tx for some indolent lymphomas
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chemo of choice for nhl
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R-CHOP
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R-CHOP
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Rituximab
Cyclophosphamide Doxorubicin Vincristine Prednisone |
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rituximab can cause a -- rxn
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infusion
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doxorubicin can cause -- toxicity
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cardio
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vincristine can cause -- toxicity
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neurotoxicity
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r-chop generally ------
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well tolerated
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r-chop givne q 21 ---
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days
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monitor -- w/ r chop
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labs
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may immunotx agent in lymphomas
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rituximab
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cd 20 only found on -- cells
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B
(both malignant and norm) |
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rituximab causes ---- and activation of ---
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apoptosis
complement |
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follicular lymphoma predominant in
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older adults
female |
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t/f
FL main s/s are B |
f
usu lack B symptoms |
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t/f
FL generally curable |
f
not generally |
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fl can transform into diffuse
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large b cell lymphoma:
b cells develop rapid growth of lymph nodes poor prognosis |
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fl tx
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radiation: localized
chlorambucin: oral, slow R-CHOP rituximab radioimmunotx stem cell transplant |
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s/s of diffuse large b cell lymphoma
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b symptoms
lymphadenopathy extranodal disease |
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diffuse large b cell lymphoma tx
no risk factors |
R-CHOP: 3-4 cycles followed by RT
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diffuse large b cell lymphoma tx
risk factors |
6-8 cycles R-CHOP followed by RT
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diffuse large b cell lymphoma tx
advanced disease |
R-CHOP
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burkitt's is --- progressive
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rapidly
tx asap |
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burkitt's tx
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intensive chemo w/ cyclophosphamide
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what's mandatory w/ burkitt's
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prophylactic tx
also check csf w/ lp |
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tx of t cell lymphomas
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like DLBCL
dose adjusted EPOCH |
