Heme/onc

Front 1

B-ALL

Back 1

CD 10, 19, 20, TdT+, sIg-

t(12;21), t(9;22)

Kids

Vincristine, prednisone, daunorubicin, asparaginase

Front 2

T-ALL

Back 2

CD1,2, cytCD3, TdT+

Adolescent males

Front 3

CLL/SLL

Back 3

CD5, 23, 19, 20

Del 11, 13, and tri 12

60+

Chlorambucil, fludarabine, cyclophosphamide, rituximab

Front 4

DLBCL

Back 4

CD 10, 19, 20, BCL6 (blocks differentiation).

t(14;18)-DLBCL a progression from follicular lymphoma
OR
EBV assoc w/ immunodef.

All ages, 60+ common

Tx: same as CLL, anti-CD20 aby

Front 5

Follicular lymphoma

Back 5

CD 10, 19, 20, sIg, BCL6 and BCL2

t(14;18): BCL6-IgH

50+

Same as CLL

Front 6

Burkitt's Lymphoma

Back 6

CD 10, 19, 20, sIg, BCL6. NO BCL2

t(8;14): c-MYC-IgH

Kids and young adults

Front 7

Mantle cell

Back 7

CD 5, 19, 20, sIg (23 negative)

t(11;14): cyclin D1-IgH

Older males

Poor px

Front 8

Marginal zone

Back 8

CD 10, 19, 20

Assoc w/ inflammation

Tx by removing enciting agent (H. pylori)

Front 9

Hairy Cell

Back 9

CD 19, 20, 25, 103, 11c

TRAP: tartrate resistant acid phosphatase

Middle age white males. Splenomegaly, hypercellular BM, pancytopenia.

Tx: gentle chemo, cladipine, pentostatin

Front 10

Multiple myeloma

Back 10

Plasma cell markers. Bence-Jones protein, M protein, punched out lesions, amyloidosis.

t(11;14)-Cyclin D1-IgH
t(4;14)-FGFR3-signals w/ cyclin D1
del 11q13-poor px

IL-6->MIP1-alpha->NF-kB->RANKL->incr osteoclast activity

Older adults, African descent

DVd, thalidomide

Front 11

Waldenstrom macroglobulinemia

Back 11

CD20, sIg, high levels monoclonal IgM. Heavy chains=light chains

Del at 6q

Older adults

Incurable, anti-CD20 aby, palliative plasmaphoresis

Front 12

Adult T cell Leukemia/Lymphoma

Back 12

CD4+, cloverleaf nuclei

HTLV encodes TAX protein that activates NF-kB

Japan, W. Africa, Caribbean

Poor px, aggressive chemo

Front 13

Mycosis fungoides

Back 13

CD4+, CLA, CCR4, CCR10, Sezary cells

Older pts, indolent at first. Progresses to Sezary dz (involves blood, BM, and skin)

Poor px

Front 14

Nodular sclerosis (HL)

Back 14

Most common HL, classical, CD 15, 30, PAX5, EBV NEGATIVE.

30's, M=F

MOPP, ABVD, or combo

Front 15

Mixed cellularity (HL)

Back 15

Classical. CD 15, 30, EBV+

Young OR old adult MALES

MOPP, ABVD, or combo

Front 16

Lymphocyte Rich (HL)

Back 16

Classical. CD 15, 30, EBV+

Males

MOPP, ABVD, or combo tx

Front 17

Lymphocyte Depleted (HL)

Back 17

CD 15, 30, and EBV+

Males

MOPP, ABVD, or combo tx

Front 18

Lymphocyte Predominant (HL)

Back 18

Non-classical. EBV negative, CD 20, BCL6 (NO CD 15, 30). Popcorn cells.

Males

MOPP, ABVD, or combo tx

Front 19

AML

Back 19

CD 33, 34

t(8;21) + inv(16)->CBF1alpha/CBF1beta fusion protein, blocks differ. Favorable px

Inv(16)-MYH11, abnormal precursors block differ. Favorable

t(15;17): RARalpha-PML. Intermediate px, tx w/ ATRA

t(11q23; var)-histone/chromatin modifier. Iatrogenic, dismal px

Front 20

CML

Back 20

CD34, low leuk alk phos

t(9;22): BCR-ABL fusion, constitutively active tyr-kinase

Adults in 50's. 3 stages: chronic, acclerated, blast crisis. Insidious onset, serendipitous dx.

Tx w/ imatinib in combo w/ hydroxyurea, kids get BMT

Front 21

MDS

Back 21

Clonal stem cell that may develop into AML. Ineffective hematopoiesis.

May be idiopathic or secondary to tx (t-MDS).

Dz of elderly (70's), hypercellular, dysplastic BM w/ ringed sideroblasts, megaloblastoid mutations, Pseudo-Pelger Huet cells.

BMT for younger pts