Escolar Documentos
Profissional Documentos
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Cell-mediated immunity
APC
Lymphokines
B-cells
surface immunoglobulin
Pre pre-B
pre-B cell
early B
mature B
cortex
medullary cords
pre-T cell
medullary thymocyte
B-Cell Cancers
Chronic lymphocytic
Prolymphocytic leukemia
LGL leukemia
leukemia
ALL
Lymphoma.org
Behavior
Indolent these lymphomas grow slowly. The majority of NHLs are considered indolent. Indolent lymphomas are generally considered incurable with chemotherapy and/or radiation therapy. Aggressive these lymphomas have a rapid growth pattern. This is the second most common form of NHL and are curable with chemotherapy. Very Aggressive these lymphomas grow very rapidly. They account for a small proportion of NHLs and can be treated with chemotherapy. Unless treated rapidly, these lymphomas can be life threatening.
CLL
CLL variants
Treatment Options
Chemotherapy Radiation Bone Marrow Transplantation Surgery Bortezomib (Velcade) Immunotherapy
Using the bodies own immune system combined with material made in a lab.
New Tests
Cytogenetics
FISH = fluorescent in situ hybridization
Flow cytometry
Rituximab : structure
Chimeric anti-human CD20 monoclonal antibody
VH VL C C1
Variable region: murine IgG1 kappa anti-CD20 Constant region: human IgG1 heavy chain and kappa light chain
Granules
Fc receptor (FcgRIII)
NK Cell
B cell
Lysis
H2O, ions, granzymes
II
III
IV
+ +/-
Idiotype Vaccines
Idiotype Rescue
Tumor Biopsy
Vaccine Production
Case 1 continued
Treatment options:
Observation Oral alkylating agents - chlorambucil CVP Rituxan
Radioimmunotherapy
Properties 90Yttrium
Half-life Energy emitter Path length 64 hours Beta (2.3 MeV) 90 5 mm
131Iodine
192 hours Gamma (0.36 MeV) Beta (0.6 MeV) 90 0.8 mm
Naked antibody
Radiolabeled antibody
Radioimmunotherapy
High response rate - 80% Moderate complete remission rate - 30% Long term responses are possible Excellent patient tolerance Myelosuppression is main toxicity Challenge: integrate RIT into the care plan for the follicular patient to maximize DFS/OS