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PBL 6 – Lymphoma and leukemia

PBL 6 – Lymphoma and leukemia. Age bracketing leukemia . 0 – 14 15 – 39 (clue: peripheral blood smear will have blasts with Auer rods) 40 – 59 > 60. How do you distinguish AML from CML?.

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PBL 6 – Lymphoma and leukemia

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  1. PBL 6 – Lymphoma and leukemia

  2. Age bracketing leukemia 0 – 14 15 – 39 (clue: peripheral blood smear will have blasts with Auer rods) 40 – 59 > 60

  3. How do you distinguish AML from CML? Perform a bone marrow aspirate. If <30% of WBCs in the marrow are blasts then you have a chronic CML, whereas if >30% of WBCs are blasts it is acute.

  4. What are more common, NHL or HL? What is the most common form of NHL? Ann Arbor classification I, II, III, IV, E, S, A, B

  5. Which of the following NHLs are associated with Epstein Bar Virus (EBV) Diffuse large B-cell lymphoma Burkett’s lymphoma Primary CNS lymphoma (common patient’s who also have…?) Follicular B-cell lymphoma

  6. Structures that may cause lower back pain

  7. Red flags for lower back pain

  8. Which NHL demonstrates the following histology?

  9. What type of NHL demonstrates this pathology? What is it’s prognosis?

  10. What type of NHL demonstrates this pathology? What is it’s prognosis?

  11. Common Lymphoma patterns

  12. Common Lymphoma patterns

  13. ABVD Doxorubicin (Adriamycin) Cytotoxic antibiotics (mitomycin), inhibit DNA and RNA synthesis by intercalation of DNA base pairs and prevent DNA repair by inhibiting topoisomerase II, i.e. inserts between DNA base pairs Bleomycin Free radical. Inhibits DNA and to a lesser extent RNA synthesis, produces single and double strand breaks in DNA possibly by free radical formation. Vinblastin Tubulin-binding drugs (aka Vinca Alkaloids including vincristine, taxol), inhibit mitosis at metaphase by binding to tubulin and inhibiting its polymerisation into microtubules, preventing spindle formation in dividing cells, i.e. arrest metaphase. Dacarbazine Alkylating agent (cyclophosphomide***, cisplatin), i.e. binds to, and forms cross-linking between, DNA strands thus interfering with cellular transcription and replication

  14. R-CHOP Rituximab Monoclonal antibody. Anti-CD20 monoclonal antibody that binds to CD20 on B lymphocytes and starts an immune response that lyses normal and malignant B cells. Apoptosis is also induced. Regeneration of normal B lymphocytes occurs. Cyclophosphamide Hydroydaunorubicin Oncovin® (Vincristine) Prednisolone

  15. Corticosteroids : MOA • Lipophilic steroid molecules diffuse through lipid membrane of cells and bind to cytoplasmic, intracellular glucocorticoid receptor • Steroid receptors undergo confirmational change which reveals DNA binding site • Receptors form dimers which enter nucleus • Dimers bind to promoter regions of target gene and cause either induction or repression of gene transcription

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