CPHON Review – Questions With Solutions
Leukemia ✔️Ans -the uncontrolled production of white blood cells
Age group ALL is most common in ✔️Ans -2-4 years
Age group AML is most common in ✔️Ans -neonates and teens
Most common type of childhood leukemia ✔️Ans -ALL
Increased risk for ALL ✔️Ans -white, male, living in Western countries,
Downs
Increased risk for AML ✔️Ans -hispanic or black, maternal cig
smoking/alcohol abuse, exposure to VP16, Downs, NFI, Monosomy 7
Signs of TLS ✔️Ans -elevated LDH, elevated Uric acid, elevated K, elevated
Phos, low Calcium
Cytochemistry stains (+) in AML dx ✔️Ans -Myeloperoxidase and Sudan
Black
Auer Rods ✔️Ans -Only seen in AML cell stains
Immunophenotyping helps determine between ✔️Ans -ALL vs AML, T-cell vs
B-cell, early pre-B vs pre-B, etc.
CNS 1 ✔️Ans -No blasts or WBC in CSF
CNS 2 ✔️Ans -<5 WBC and <5 blasts
CNS 3 ✔️Ans ->5 WBC and >5 blasts, +/- CNS leuk signs and symptoms
< 50,000 WBC at dx ✔️Ans -SR
>50,000 WBC at dx ✔️Ans -HR
1-9 years old at dx ✔️Ans -SR
,<1 year and =>10 years old at dx ✔️Ans -HR
Slow early response to chemo during induction and consolidation ✔️Ans -HR
Rapid early response to chemo during induction and consolidation ✔️Ans -SR
ALL Induction ✔️Ans -First phase, goal = marrow remission, eliminate blasts,
>97% achieve remission
Induction for ALL Agents ✔️Ans -VCR, steroids, asparaginase, anthracyclines
Consolidation/Intensification for ALL ✔️Ans -goal= eradicate remaining
leukemia, treat sanctuary sites and intensity tx of CNS (IT and or XRT) *3
weeks in a row of CNS tx w LP & ITs
Consolidation/Intensification for ALL Agents ✔️Ans -cytox, ARA-C, 6MP, VCR,
Peg, ITs
Maintenance for ALL ✔️Ans -goal= remain in remission, mostly out patient
(IM, DI, Maint.),
IM Agents for ALL ✔️Ans -VCR, MTX, PEG, ITs
DI Agents for ALL ✔️Ans -Cytox, ARAC, 6TG, VCR, Dox, Peg, ITS, need lots of
tranfx and CBC checks
Maintenance Agents for ALL ✔️Ans -Dosing based on counts; VCR, PO
steroids, PO 6MP, PO MTX
ALL early relapse ✔️Ans -<6 mo off therapy
ALL late relapse ✔️Ans ->6 mo off therapy
Blinatumomab ✔️Ans -targets CD19 antigen on B cells
AML survival rate ✔️Ans -40-50%
AML Therapy ✔️Ans -intense chemo with increased risk of infection, isolate
, AML therapy agents ✔️Ans -anthracyclines, HD ARA-C, Asparaginase,
steroids, thioguanine, CNS prophylaxis w ARAC
AML Relapse without prior BMT ✔️Ans -will go to URD PSCT
AML Relapse after BMT ✔️Ans -aza/ven, 2nd BMT, DLI
Lymphoma ✔️Ans -3rd most common type of peds CA, neoplasm of immune
system cells that can arise anywhere in the body, cells "clump" together to
form a tumor
B-cells ✔️Ans -originate from BM, lymph nodes and spleen and make
antibodies
T-cells ✔️Ans -originate in thymus and attack invaders
NK cells ✔️Ans -play a role in cytotoxicity against tumors and viral cells
Mature B Cell Lymphomas ✔️Ans -Burkitt and Diffuse Large B Cell (DLBCL)
Chemo 3-6 mos, intense
Cytox, VCR, ARA-C, MTX, etop, pred, doxo and ITs based on staging
Lymphoblastic Lymphomas ✔️Ans -T and B cell
Large Cell Lymphomas ✔️Ans -Anaplastic Large Cell (ALCL)
NHL risk factors ✔️Ans -EBV, HIV, immunosuppression from any type of
transplant, T-deplete grafts, SCID, WAS
Burkitt lymphoma ✔️Ans -B-cell malignancy, RAPID growing and tumor
burden can double in 24 hrs, 40-50% of NHL dxs, can have <25% blasts in BM,
presents usually w abd mass
Lymphoblastic Lymphoma ✔️Ans -Present with airway compromise or organ
obs and requre immediate intervention, 90% is T-cell other 10% is B-cell
Leukemia ✔️Ans -the uncontrolled production of white blood cells
Age group ALL is most common in ✔️Ans -2-4 years
Age group AML is most common in ✔️Ans -neonates and teens
Most common type of childhood leukemia ✔️Ans -ALL
Increased risk for ALL ✔️Ans -white, male, living in Western countries,
Downs
Increased risk for AML ✔️Ans -hispanic or black, maternal cig
smoking/alcohol abuse, exposure to VP16, Downs, NFI, Monosomy 7
Signs of TLS ✔️Ans -elevated LDH, elevated Uric acid, elevated K, elevated
Phos, low Calcium
Cytochemistry stains (+) in AML dx ✔️Ans -Myeloperoxidase and Sudan
Black
Auer Rods ✔️Ans -Only seen in AML cell stains
Immunophenotyping helps determine between ✔️Ans -ALL vs AML, T-cell vs
B-cell, early pre-B vs pre-B, etc.
CNS 1 ✔️Ans -No blasts or WBC in CSF
CNS 2 ✔️Ans -<5 WBC and <5 blasts
CNS 3 ✔️Ans ->5 WBC and >5 blasts, +/- CNS leuk signs and symptoms
< 50,000 WBC at dx ✔️Ans -SR
>50,000 WBC at dx ✔️Ans -HR
1-9 years old at dx ✔️Ans -SR
,<1 year and =>10 years old at dx ✔️Ans -HR
Slow early response to chemo during induction and consolidation ✔️Ans -HR
Rapid early response to chemo during induction and consolidation ✔️Ans -SR
ALL Induction ✔️Ans -First phase, goal = marrow remission, eliminate blasts,
>97% achieve remission
Induction for ALL Agents ✔️Ans -VCR, steroids, asparaginase, anthracyclines
Consolidation/Intensification for ALL ✔️Ans -goal= eradicate remaining
leukemia, treat sanctuary sites and intensity tx of CNS (IT and or XRT) *3
weeks in a row of CNS tx w LP & ITs
Consolidation/Intensification for ALL Agents ✔️Ans -cytox, ARA-C, 6MP, VCR,
Peg, ITs
Maintenance for ALL ✔️Ans -goal= remain in remission, mostly out patient
(IM, DI, Maint.),
IM Agents for ALL ✔️Ans -VCR, MTX, PEG, ITs
DI Agents for ALL ✔️Ans -Cytox, ARAC, 6TG, VCR, Dox, Peg, ITS, need lots of
tranfx and CBC checks
Maintenance Agents for ALL ✔️Ans -Dosing based on counts; VCR, PO
steroids, PO 6MP, PO MTX
ALL early relapse ✔️Ans -<6 mo off therapy
ALL late relapse ✔️Ans ->6 mo off therapy
Blinatumomab ✔️Ans -targets CD19 antigen on B cells
AML survival rate ✔️Ans -40-50%
AML Therapy ✔️Ans -intense chemo with increased risk of infection, isolate
, AML therapy agents ✔️Ans -anthracyclines, HD ARA-C, Asparaginase,
steroids, thioguanine, CNS prophylaxis w ARAC
AML Relapse without prior BMT ✔️Ans -will go to URD PSCT
AML Relapse after BMT ✔️Ans -aza/ven, 2nd BMT, DLI
Lymphoma ✔️Ans -3rd most common type of peds CA, neoplasm of immune
system cells that can arise anywhere in the body, cells "clump" together to
form a tumor
B-cells ✔️Ans -originate from BM, lymph nodes and spleen and make
antibodies
T-cells ✔️Ans -originate in thymus and attack invaders
NK cells ✔️Ans -play a role in cytotoxicity against tumors and viral cells
Mature B Cell Lymphomas ✔️Ans -Burkitt and Diffuse Large B Cell (DLBCL)
Chemo 3-6 mos, intense
Cytox, VCR, ARA-C, MTX, etop, pred, doxo and ITs based on staging
Lymphoblastic Lymphomas ✔️Ans -T and B cell
Large Cell Lymphomas ✔️Ans -Anaplastic Large Cell (ALCL)
NHL risk factors ✔️Ans -EBV, HIV, immunosuppression from any type of
transplant, T-deplete grafts, SCID, WAS
Burkitt lymphoma ✔️Ans -B-cell malignancy, RAPID growing and tumor
burden can double in 24 hrs, 40-50% of NHL dxs, can have <25% blasts in BM,
presents usually w abd mass
Lymphoblastic Lymphoma ✔️Ans -Present with airway compromise or organ
obs and requre immediate intervention, 90% is T-cell other 10% is B-cell
