Assalamualaikum & Happy Saturday :)
Life must go on..
PROFESSIONAL tinggal lagi 56 days.
So, today just for simple recaps on lymphoma. Keep calm and bear with me with all sorts of jargon-medical terms that i will use in this entry.
Haha, no interesting events happened for me to share with you all apart from me being so nervous thinking about this coming exam.
So!
HODGKIN LYMPHOMA
How much do you know ?
- Lymphoma as name imply is the malignant proliferation of the lymphocyte
- Bimodal age presentation; young adult and elderly
- Male more common
- 4 types of classical Hodgkin will affect the prognosis
- Good prognosis
- Mixed cellularity
- Lymphocyte rich
- Nodular sclerosing
- Poor prognosis
- Lymphocyte depleted (<40% 5 year survival rate)
- Presented with lymph node swelling; rubbery commonly at cervical however axillary and inguinal can be presented too.
- Other presentation; constitutional symptoms like nighT sweat, fever, loss of weight, pruritus and lethargy.
- Presentation of complication; SVC obstruction
- Associations
- EBV
- Autoimmune; RA, SLE
- Sarcoidoisis
- Post transplantation
- obese
- family history 1st degree
- Reed sternberg cell? Owl eyes :)
- O/E; cachexic, lymphadenopathy, hepatosplenomegaly
- IX;
- FBC
- LDH
- ESR
- Serum Ca
- FNAC
- CT TAP
- BMAT
- Staging by Ann Arbour; 4 stages with A- no systemic symptoms apart from pruritus. B-symptoms consist of loss of weight 10% within 6 month, drenching night sweat and fever >38. B symptoms suggest for more extensive disease.
- Management
- For further history taking, physical examination and investigations
- For chemoradiotheraphy
- Favourable prognosis can have 3-4 cycles of ABVD regimes; adriamycin, bleomycin, vinblastine, dacarbazine followed by radiotherapy
- For advanced disease; opt for BEACOPP; bleomycin, etoposide, adriamycin, adriamycin, cyclophosphamide, oxaliplatin, procarbazine, prednisolone
- Problems with BEACOPP; higher rates of toxicity including reversible bone marrow suppression, secondary malignancies, sterility, and rare cases of fatal sepsis.
- High dose chemotherapy and autologous HCT should be considered as the treatment of choice for the following subsets of patients:
- Early relapse (less than 12 months after treatment) or induction failure.
- Second relapse after conventional treatment for first relapse.
- Generalized systemic relapse even beyond 12 months.
- Monitor side effect for chemotherapy and radiotherapy
- Monitor for complications; SVC obstruction, infection
- International Prognostic Score (IPS)
Ref; Oxford Handbook
