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Flashcards in NHL Deck (19)
1

What is the typical translocation of ALCL?

t(2;5)(p23:q35)
Leads to constitutional activation of ALK

2

Name 4 common sites of extranodal disease in ALCL

Skin, soft tissue, bone, lung

3

What are hallmark cells?

Typical cells of ALCL: horseshoe-shaped, eccentric nucleus

4

Name the 3 subtypes of Burkitt lymphoma; state how often it is associated with EBV positivity

Sporadic (10-15%)
Endemic (95%)
Related to immunodeficiency (40%)

5

Name the typical translocations associated with Burkitt

t(2;8) - Ig K chains
t(8;14) - IgH
t(8;22) - Ig light chains

6

What is the immunophenotype associated with mature B cell lymphoma (Burkitt, DLBCL)?

(+)ve: CD19, C20, CD22, CD79a, sIg
(-)ve: CD10, tdT, CD5, CD23

7

What is the outcome of Burkitt lymphoma, both 1) localized and 2) disseminated?

1) EFS: 90%, OS 95%
2) EFS: 80%

8

Name 2 novel prognostic risk factors in ALCL

1) Anti-ALK antibodies in blood at diagnosis (protector effect)
2) Copy number of NPM-ALK variants in bone marrow at diagnosis (associated with higher relapse rates)

9

Name the 3 histologic variants of DLBCL

Centroblastic; immunoblastic; anaplastic

10

Define Group A for localized mature B-cell neoplasm
As per the current standard of care, what is the treatment (group A)?

Fully resected Stage I or stage II disease
COPAD * 2

11

When do relapses occur in ALCL?

Within 2 years of initial treatment

12

What are the late effects of therapy of NHL treatment?

Very rare compared to other cancers
Cardiotoxicity
HCV infections from transfusion (old studies)
Second malignancies (5% at 20y)

13

Risk factors for PTLD in solid organ transplants

- Type of transplant (worse with heart, lung, GI, compared with kidney or liver)
- EBV negativity in recipient
- CMV negativity (less consistently reported than EBV)
- Degree of immunosuppression

14

Risk factors for PTLD in HSCT

- T-cell depleted stem cell source
- Conditioning regimen including antithymocyte globulin

15

Late effects of HD attributable to radiation therapy (7)

- Growth impairment
- Cardio-vascular disease (coronary artery disease, valvular disease, pericardial disorders)
- Stroke
- Infections (splenic radiation)
- Thyroid dysfunction
- Infertility
- Lung fibrosis
- Second malignancies

16

Late effects of HD attributable to chemotherapy (4)

- Cardiomyopathy (anthracyclines)
- Lung dysfunction (bleomycin)
- Male infertility (alkylating agents, procarbazine)
- Hematologic malignancies (alkylating agents, topoisomerase II inhibitors)

17

Risk factors for anthracycline-related toxicity (4)

- Younger age
- Female sex
- Cumulative doses of anthracyclines
- Combination of mediastinal radiation

18

Risk factors for lung toxicity (3)

- Cumulative doses of toxic agents: bleomycin, BCNU, CCNU
- Combination of chemotherapy and lung radiation
- Younger age

19

Name 6 prognostic factors in ALCL

Age
Histologic subtype
High MDD
High MRD
Increased copy number variants of ALK in bone marrow at diagnosis
Absence of anti-ALK Ig in peripheral blood at diagnosis