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Therapeutics Hem/Onc Hecht
Final Exam Lymphoma
31
Agriculture
2nd Grade
02/15/2011
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Term
Symptoms of Lymphoma
 Definition
  • Symptoms come and go
  • Adenopathy and complications
  • Pruritis
  • B symptoms (fever, night sweats, weight loss)
  • Bone marrow involvement = myelosuppression
Term
Stage I Lymphoma
 Definition
Single LN region OR single extra lymphatic organ or site
Term
Stage II Lymphoma
 Definition
> 2 LN regions on same side of the diaphragm
Term
Stage III Lymphoma
 Definition
Involves LN regions on both sides of diaphragm
Term
Stage IV Lymphoma
 Definition
  • Disseminated multi-focal involvement
  • Bone marrow involvement
Term
Poor Prognostic Factors for Hodgkin's Disease
 Definition
  • Age > 50
  • Elevated ESR
  • B symptoms
  • Large mediastinal mass
  • > 3 sites of involvement
  • Bulky adenopathy
  • Lymphocyte-depletion histologic type
  • Advanced stage
Term
Side Effects of Radiation for treatment of Hodgkin's Disease
 Definition
  • Xerostomia
  • Hypothyroidism
  • Pneumonitis
  • Cardiotoxicity
  • Infertility
Term
Drugs Included in the MOPP Regimen
 Definition
  • Mechlorethamine
  • Vincristine
  • Procarbazine
  • Prednisone
Term
Drugs included in the ABVD regimen
 Definition
  • Doxorubicin
  • Bleomycin
  • Vinblastine
  • Dacarbazine
Term
Gold Standard Chemotherapy for Hodgkin's Disease
 Definition
ABVD
Term
Drugs Included in the Stanford V Regimen
 Definition
  • Doxorubicin
  • Vinblastine
  • Mechlorethamine
  • Etoposide
  • Vincristine
  • Bleomycin
  • Prednisone
Term
Hodgkin's Disease Treatment in Early Stage: Favorable
 Definition

Stage IA, IIA (No B Symptoms)

  • historically gave radiation
  • Chemotherapy (2 cycles) + involved node radiation
Term
Hodgkin's Disease Treatment in Early Stage: Unfavorable
 Definition

Stage IB, IIB (B Symptoms)

  • Chemotherapy (4 cycles) + involved node radiation
Term
Hodgkin's Disease Treatment in Advanced Stage: Stage III-IV
 Definition
Chemotherapy
Term
Hodgkin's Disease Salvage Therapy: Relapse < 1 yr from initial therapy
 Definition
  • Radiation alone as initial therapy --> start chemo
  • Chemo as initial therapy --> BMT
Term
Hodgkin's Disease Salvage Therapy: Relapse > 1 yr from initial therapy
 Definition
Same treatment as before
Term
ABVD: ADRs
 Definition

Quick

  • Hypersensitivity
  • Extravasation

Short Term

  • NV
  • Myelosuppression
  • Mucositis
  • Alopecia
  • Neuropathies
  • Red secretions
  • Blood clots

Long Term

  • Cardiotoxicity
  • Pulmonary Toxicity
Term
Stanford V: ADRs
 Definition

Quick

  • Hypersensitivity
  • Extravasation

Short Term

  • NV
  • Myelosuppression
  • Mucositis
  • Alopecia
  • Neuropathies
  • Red secretions
  • Blood clots

Long Term

  • Cardiotoxicity
  • Pulmonary Toxicity
Term
Non-Hodgkin's Lymphoma: Poor Prognostic Factors
 Definition
  • Age > 60
  • Elevated LDH
  • Poor performance status
  • Ann Arbor Stage III or IV
  • > 2 extranodal sites
Term
NHL Follicular Treatment: Early Stage I/II
 Definition
  • Observation
  • Localized XRT
  • +/- Chemo
Term
NHL Follicular Treatment: Early Stage III/IV
 Definition
  • Fludarabine + Rituximab
  • IF cannot take the above, then try Chlorambucil
Term
NHL Gastric MALT Treatment: Early Stage I/II
 Definition
Treat H. pylori
Term
NHL Gastric MALT Treatment: Early Stage III/IV
 Definition
  • Chemo -- CHOP + Rituximab
  • H. pylori treatment
Term
NHL Diffuse Large B Cell Treatment: Early Stage I/II
 Definition
  • CHOP + Rituximab
  • Radiation

 
Term
NHL Diffuse Large B Cell Treatment: Advanced Stage III/IV
 Definition
CHOP + Rituximab
Term
Drugs included in R-CHOP
 Definition
  • Rituximab
  • Cyclophosphamide
  • Doxorubicin
  • Vincristine
  • Prednisone
Term
R-CHOP: ADRs
 Definition

Quick

  • Hypersensitivity
  • Extravasation

Short Term

  • NV
  • Myelosuppression
  • Mucositis
  • Alopecia
  • Neuropathies
  • Red secretions

Long Term

Cardiac Toxicity
Term
NHL Treatment -- Highly Aggressive: Burkitt's and Lymphoblastic Lymphoma Treatment
 Definition

All Stages I-IV

  • Alkylating agent
  • Anthracycline
  • HD MTX
  • IT Chemo
  • Possibly hyper CVAD
Term
Drugs included in Hyper CVAD
 Definition

Course 1

  • Cyclophosphamide
  • Mesna
  • Vincristine
  • Doxorubicin
  • Dexamethasone

Course 2

  • MTX
  • Leucovorin
  • Cytarabine
Term
Hyper CVAD: ADRs
 Definition

Quick

  • Hypersensitivity
  • Extravasation

Short Term

  • NV
  • Myelosuppression
  • Mucositis (MTX)
  • Alopecia
  • Neuropathies
  • Red secretions
  • Hemorrhagic cystitis

Long Term

Cardiac toxicity
Term
Types of Radiation for Hodgkin's Lymphoma
 Definition

Extended-Field/Regional Radiotherapy

  • Mantle irradiation
  • Para-aortic irradiation
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