Hodgkins Lymphoma

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Transcript of Hodgkins Lymphoma

  • 1. 1 | P a g e (Hodgkin's lymphoma) HL ( ) - (lymphoid malignancy) , 1832 2-3 - ( excisional lymph node biopsy) - .., ... - ... ( classic) 1- NS (80%) 2- MS (15%) 3- LD (02%) 4- (03%) LR Pop corn Cells 5 % - '' '' - CD19 CD20 CD15 CD30 5- (NLPHD) (20-50 ) -''- '' , 1-2 % , , , , - ( cytoplasm) , , , (abundant, homogeneous, amphophilic, finely granular ) '' '' ( )

2. 2 | P a g e - - , -( lymph node) - - - CD30 (Ki-1) CD15 CD30 - , CD15 , - - - - ( EBV) 50% EBV-positive 100 % ... EBV-positive - - ... - ( mutation) - ( mutation) , - 15-40 55 ( - Epstein-Barr virus) - HIV, AIDS (Symptoms & Signs ) (Axilla), ( groin) - (Lymphnode Enlargement) ( , ), 3. 3 | P a g e (occipital) (epitrochlear) - , , , , , 10% (Pel-Ebstein fever) 1-2 1-2 - , , (hemoptysis) 10% (30% ) / (5% ) (Superior vena cava syndrome) , , (Imaging) .. , ( Pelvis) , ... (mediastinal mass) ... ... (Microscopy) FNAC - , Biopsy FNAC (Excision) Bone marrow Biopsy ... -( anemia), (lymphopenia), 4. 4 | P a g e ... -... ( worse prognosis) ... ... ( ) ( ALP) - IL-6, IL-10 CD25 ( IL-2 ) (Stages) , , , (1971) I - II III - IV - - (bone marrow) (spleen) - - -/ (cyclophosphamide, melphalan, BCNU, Ara-C, methotrexate und etoposide) -/ , , 5. 5 | P a g e 30-36 Gy 20-30 Gy 30-44 Gy MOPP (mechlorethamine, vincristine, procarbazine, prednisone) ABVD (Adriamycin [doxorubicin], bleomycin, vinblastine, dacarbazine) Stanford V (doxorubicin, vinblastine, mustard, bleomycin, vincristine, etoposide, prednisone) BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) MOPP ABVD Stanford V 12 MOPP 28 6 Mechlorethamine: 6 mg/m2 , days 1 and 8 Vincristine: 1.4 mg/m 2 , days 1 and 8 Procarbazine: 100 mg/m 2 , days 1-14 Prednisone: 40 mg/m2 , days 1-14, cycles 1 and 4 only ABVD 28 6 Adriamycin: 25 mg/m2 , days 1, 15 Bleomycin: 10 mg/m2 , days 1, 15 Vinblastine: 6 mg/m 2, days 1, 15 Dacarbazine: 375 mg/m 2 , days 1, 15 The Stanford V Vinblastine: 6 mg/m 2 , weeks 1, 3, 5, 7, 9, 11 Doxorubicin: 25 mg/m 2 , weeks 1, 3, 5, 9, 11 Vincristine: 1.4 mg/m 2 , weeks 2, 4, 6, 8, 10, 12 Bleomycin: 5 units/m 2 , weeks 2, 4, 8, 10, 12 Mechlorethamine: 6 mg/m 2 , weeks 1, 5, 9 Etoposide: 60 mg/m2 twice daily, weeks 3, 7, 11 Prednisone: 40 mg/m2 , every other day, weeks 1-10, tapered weeks 11, 12 XRT to bulky sites 2-4 weeks following the end of chemotherapy BEACOPP , 8 Bleomycin: 10 mg/m 2 , day 8 Etoposide: 200 mg/m 2 , days 1-3 6. 6 | P a g e Doxorubicin: 35 mg/m 2 , day 1 Cyclophosphamide: 1,250 mg/m2 , day 1 Vincristine: 1.4 mg/m2 , day 8 Procarbazine: 100 mg/m2 , days 1-7 Prednisone: 40 mg/m 2 , days 1-14 ICE (ifosfamide, carboplatin, etoposide) DHAP (cisplatin, cytarabine, prednisone) ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) ICE Ifosfamide: 5 g/m 2 , day 2 Mesna: g/m2 , day 2 Carboplatin: AUC 5, day 2 Etoposide: 100 mg/m 2 , days 1-3 DHAP Cisplatin: 100 mg/m 2 , day 1 Cytarabine: 2 g/m 2 , given twice on day 2 Dexamethasone: 40 mg, days 1-4 EPOCH etoposide, vincristine, and doxorubicin 96 Etoposide: 50 mg/m 2 , days 1-4 Vincristine: 0.4 mg/m 2 , days 1-4 Doxorubicin: 10 mg/m 2 , days 1-4 Cyclophosphamide: 750 mg/m 2 , day 5 Prednisone: 60 mg/m 2 , days 1-6 (Prognosis) 85% 98% > 45 IV < 10.5 g/dl < 600/ L or 15000/ L 7. 7 | P a g e