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Lymphoma, Clonal proliferation of cells - Coggle Diagram

- - - - FBC
      - +/- LN biopsy
      - Not that helpful esp in early presentation
  - - - Immunohistochemistry
        
        Parrafin - embedded material
      - Flow cytometry
        
        Fresh tissue to produce suspensions
    - - Conventional
        
        G banding
        
        Dividing cells
      - FISH
        
        Fixed tissue
        
        Non random translocatoins
    - - In situ hybridisation
        
        Labelled DNA or RNA probes
      - PCR techniques
        
        DEtec clonalty of fresh or fixed material
      - Microarray technology
        
        Study of altered gene expression profiling
      - Next generation sequencing
- - - - CD 19 / BCMA
- - - - Chemotherapy pt
    - - day 10-12 after chemo
    - - Some evidence for prophylactic antibiotics - Ciprofloxacin in high risk pts
      - Role of G-CSF
      - Peg Filgsatrim vs Filgrastrim
  - - - Burkitts
      - B cell ALL
      - Lymphobastic lypmhoma
      - AML with hyperleukocytosis
    - - Acute Renal failure - Urate nephropathy
      - Electrolyte / Metabolic Disturbances
        Ca / Po4 / K
    - - Aggressive hydration
      - Allopurinol or Rasburicase
      - If phosphate elevated - Aluminium Hydroxide
      - Don't repalce Ca unless pt symptomatic
    - - K > 6
      - PhO4 > 1.45
      - Ca <1.75
      - LDH x2 ULN
      - Creastinine clearance <50
      - One or more
  - - - Typically transfuse Hb <8
      - Concurrent hx of IHD <10
    - - Typically transfuse <10 x10^9
      - ABO matched platelets are preffered but crossing of groups is allowed
- - - - Nodular sclerosing - 80%
      - Mixed cellularity
      - 80-85%
      - Lymphocyte Rich
      - Lymphocyte Depleted
      - Good prognosis
  - - - Good prognosis
      - Agressive
      - Indolent
    - - Bad prognosis
      - Aggressive
      - Indolent
- - - - 4 sub catagories
    - - Good prognosis
- - - - Asia predominates
      - HTLV1 - Hyman t cell leukaemia virus 1
      - EBV
- - - - Involvement of singkle lymph node region or lymphoid structure
        eg Spleen, thymus, Waldeyer's ring
    - - Involvement of two or more lymph node regions on the same side of the diaphragm
    - - Involvement of lymph regions or structures on both sides of diaphragm
    - - Involvement of lymph regions or structuress on both sides of the diaphragm
    - - Inveolvement of extranodal sites beyond that designated
    - - All Stages
        
        A
        
        no symptoms
        
        B
        
        Fever 38
        Seats
        Weight loss 10% over 6m
      - For Stages I-III
        
        E
        
        Inveolvement of a single extranodal site contiguous or proximal to known nodal sites