Chapter 97. Malignant Lymphomas
What is considered to be the regimen of choice for the initial treatment of diffuse large B-cell lymphoma that does not express any high risk genetic rearrangements?
D. Fludarabine and rituximab
Option A: Correct. R-CHOP is the preferred regimen for standard risk diffuse large B-cell lymphoma. The number of cycles recommended depends on multiple factors including stage and presence of negative prognostic features.
Option B: Incorrect. R-Hyper-CVAD is used in the treatment of highly aggressive lymphomas where R-CHOP is insufficient such as HIV-associated lymphoma and Burkitt's lymphoma.
Option C: Incorrect. DA-EPOCH-R is used in the treatment of highly aggressive lymphomas where R-CHOP is insufficient such as double-hit lymphoma and HIV-associated lymphoma.
Option D: Incorrect. Fludarabine and rituximab is primarily used in the treatment of low-grade follicular lymphoma.
Which of the following is a negative prognostic factor and included in the follicular lymphoma international prognostic index (FLIPI)?
C. LDH lower than normal levels
Option A: Incorrect. Hemoglobin < 12 g/dL is a negative prognostic indicator.
Option B: Correct. Patients over the age of 60 who have lymphoma have a worse prognosis than younger patients.
Option C: Incorrect. LDH greater than upper limit of normal is a negative prognostic indicator.
Option D: Incorrect. Patients with advanced disease, stages III and IV have a worse prognosis than early stage patients.
A 43-year-old woman was recently diagnosed with stage III low-grade follicular lymphoma. Other than her cancer diagnosis she is in good health. Because she is young, the oncologist wishes to utilize a regimen that will not affect her ability to undergo autologous stem cell transplant if needed in the future. Which of the following regimens should be initiated in this patient?
A. Bendamustine with rituximab
B. Idelsalib with rituximab
C. Fludarabine with rituximab
D. Lenalidomide with rituximab
Option A: Correct. Bendamustine with rituximab is one of the potential first-line treatments for patients with follicular lymphoma. Other potential first-line treatments include R-CHOP and ...