299. Pediatric Lymphomas (Pediatric Oncology)

You are here: Home / Uncategorized / 299. Pediatric Lymphomas (Pediatric Oncology)

299. Pediatric Lymphomas (Pediatric Oncology)

299. Pediatric Lymphomas (Pediatric Oncology)

 

 

CATEGORY: Medical & Medicine – 500 Courses

COURSE NUMBER: 299

FEES: 555/- INR only

CERTIFICATE VALIDITY: Lifetime

CERTIFICATES DELIVERY: In 48 hours

BOOKS/ MANUALS: Pages

Syllabus

1 Introduction and Historical Back-
ground: Pediatric Hodgkin Lymphoma

S.S. Donaldson
1.1 The Way It Was . . . . . . . . . . . . . . . . . . . . 1
1.2 Lessons from the Children . . . . . . . . . . . . . 3
1.3 The Hidden Secrets –
The Discovery of Late Eff ects . . . . . . . . . . . 3
1.4 Current Optimal Management . . . . . . . . . . 4
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2 Biology and Pathology of Hodgkin’s
Disease
R.E. Hutchinson and A. Uner
2.1 History of Hodgkin’s Disease
Pathologic Classifi cation . . . . . . . . . . . . . . 7
2.2 Lineage of Hodgkin Reed-Sternberg
cells; B-cell phenotype . . . . . . . . . . . . . . . 9
2.3 Some Evidence of Antigen-Presenting
Function . . . . . . . . . . . . . . . . . . . . . . . . 10
2.4 Apoptosis . . . . . . . . . . . . . . . . . . . . . . . . 10
2.5 NF-kappaB . . . . . . . . . . . . . . . . . . . . . . . 11
2.6 Jak/STAT Pathways . . . . . . . . . . . . . . . . . . 12
2.7 Tumor Necrosis Factor Receptor
(TNFR) Family . . . . . . . . . . . . . . . . . . . . . 12
2.8 Tumor Necrosis Factor Receptor-Associated
Factors (TRAFs) . . . . . . . . . . . . . . . . . . . . 12
2.9 Cytokines and Chemokines . . . . . . . . . . . . 13
2.10 Cytogenetics . . . . . . . . . . . . . . . . . . . . . . 14
2.11 Gene Profi le . . . . . . . . . . . . . . . . . . . . . . 14
2.12 Association with EBV . . . . . . . . . . . . . . . . 14
2.13 Pathology of Classical
Hodgkin Lymphoma . . . . . . . . . . . . . . . . 16
2.14 Immunophenotype of
Classical HRS cells . . . . . . . . . . . . . . . . . . 17
2.15 Flow Cytometry . . . . . . . . . . . . . . . . . . . . 18

2.16 Histologic Classifi cation of CHL . . . . . . . . . 19
2.16.1 Nodular Sclerosis HL . . . . . . . . . . . 19
2.16.2 Mixed Cellularity HL . . . . . . . . . . . . 20
2.16.3 Nodular Lymphocyte Rich CHL . . . . . 21
2.16.4 Lymphocyte Depleted HL . . . . . . . . 22
2.17 Nodular Lymphocyte Predominant
Hodgkin Lymphoma (NLPHL) . . . . . . . . . . . 22
2.18 Hodgkin Lymphoma in the Setting of HIV
Infection . . . . . . . . . . . . . . . . . . . . . . . . 23
2.19 Bone Marrow Involvement and
Histologic Staging . . . . . . . . . . . . . . . . . . 23
2.20 Pathology of Relapse and
Second Malignancy . . . . . . . . . . . . . . . . . 24
2.21 Diff erential Diagnosis of HL . . . . . . . . . . . . 25
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
3 Treatment of Pediatric Hodgkin
Lymphoma
M.M. Hudson, C. Schwartz, and L.S. Constine
3.0 Introduction . . . . . . . . . . . . . . . . . . . . . . 35
3.1 Clinical Presentation . . . . . . . . . . . . . . . . . 36
3.1.1 Systemic Symptoms . . . . . . . . . . . . 37
3.1.2 Laboratory Evaluation . . . . . . . . . . . 37
3.1.3 Immunologic Status . . . . . . . . . . . . 38
3.2 Diff erential Diagnosis . . . . . . . . . . . . . . . . 39
3.3 Diagnostic Evaluation and Staging . . . . . . . 40
3.4 Prognostic Factors . . . . . . . . . . . . . . . . . . 43
3.5 Combination Chemotherapy . . . . . . . . . . . 45
3.6 Chemotherapy Alone Versus Combined
Modality Therapy . . . . . . . . . . . . . . . . . . . 49
3.7 Risk-Adapted Therapy . . . . . . . . . . . . . . . . 51
3.7.1 Treatment of Low-Risk Disease. . . . . . 51
3.7.2 Treatment of Intermediate- and
High-Risk Disease . . . . . . . . . . . . . . 53
3.8 Principles of Radiation Therapy . . . . . . . . . . 54
3.8.1 Volume Considerations . . . . . . . . . . 56
3.8.2 Dose Considerations . . . . . . . . . . . . 58
3.8.3 Energy . . . . . . . . . . . . . . . . . . . . . 59

VIII
3.9 Summary Recommendations for Primary
Disease/Selection of Therapy . . . . . . . . . . . 59
3.10 Acute Eff ects of Therapy . . . . . . . . . . . . . . 59
3.10.1 Chemotherapy Side-Eff ects . . . . . . . . 59
3.10.2 Radiation Side-Eff ects . . . . . . . . . . . 61
3.11 Future Directions . . . . . . . . . . . . . . . . . . . 61
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

4 Treatment of Relapsed/Refractory
Hodgkin Lymphoma
T.M. Trippett and A. Chen
4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . 67
4.2 Strategies for Re-induction . . . . . . . . . . . . 67
4.2.1 Role of Re-induction Chemotherapy . . 68
4.2.2 Standard Re-induction with ICE . . . . . 68
4.2.3 Re-induction with Ifosfamide/
Vinorelbine (IV) . . . . . . . . . . . . . . . 69
4.3 High-Dose Therapy . . . . . . . . . . . . . . . . . . 70
4.3.1 Immunomodulation as a Therapeutic
Strategy to Augment High-Dose
Therapy . . . . . . . . . . . . . . . . . . . . 71
4.3.2 Reduced-Intensity/Non-myeloablative
Allogeneic Stem cell Transplantation . . 72
4.4 Salvage Strategies Following Transplantation 72
4.4.1 Combination Chemotherapy with
Gemcitabine/Vinorelbine (GEM/VRB) . 73

4.4.2 Molecular Targeting of the
NF-κB Pathway . . . . . . . . . . . . . . . . 74
4.4.2.1 Activation of NF-κΒ . . . . . . . . 74
4.4.2.2 Inhibition of NF-κB Through
Proteasome Inhibition . . . . . 75
4.4.2.3 Adult Clinical Trials . . . . . . . . 76
4.4.2.4 Pediatric Clinical Trials . . . . . . 77
4.4.2.5 Novel Retrieval Strategies
Incorporating Proteasome
Inhibition with Bortezomib . . 77
4.4.3 Targeted Immunotherapy Strategies . . 77
4.4.3.1 Epstein-Barr Virus

Directed Therapy . . . . . . . . . 77
4.4.3.2 Monoclonal Antibodies Targeting
Receptors Expressed in HL . . . 78
4.4.3.3 Radiolabeled Immunoglobulin
Therapy in HL . . . . . . . . . . . 79
4.5 Future Considerations . . . . . . . . . . . . . . . 79
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

5 Non-Hodgkin’s Lymphoma:
Introduction and Historical Background
S.B. Murphy
5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . 85
5.2 The Early Era, Pre-1970 . . . . . . . . . . . . . . . 86
5.3 The Latter Era, Post-1970s . . . . . . . . . . . . . 86
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
6 Biology and Pathology of Pediatric
Non-Hodgkin Lymphoma
S.L. Perkins and S.W. Morris
6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . 91
6.2 Non-Hodgkin Lymphoma . . . . . . . . . . . . . 91
6.3 Pathologic Analysis. . . . . . . . . . . . . . . . . . 93
6.3.1 Morphology . . . . . . . . . . . . . . . . . 93
6.3.2 Immunophenotypic Analysis . . . . . . . 94
6.3.3 Molecular and Cytogenetic Analysis . . 95
6.3.4 WHO Classifi cation of

Hematolymphoid Tumors . . . . . . . . 100
6.4 Molecular Pathogenesis of Pediatric NHL . . 101
6.5 Burkitt Lymphomas . . . . . . . . . . . . . . . . 101
6.5.1 Pathology . . . . . . . . . . . . . . . . . . 101
6.5.2 Biology and Molecular Mechanisms . 104
6.6 Diff use Large B-Cell Lymphomas . . . . . . . 107
6.6.1 Pathology . . . . . . . . . . . . . . . . . . 107
6.6.2 Biology and Molecular Mechanisms . 109
6.7 Anaplastic Large-Cell Lymphoma . . . . . . . 112
6.7.1 Pathology . . . . . . . . . . . . . . . . . . 112
6.7.2 Biology and Molecular Mechanisms . 117
6.8 Lymphoblastic Lymphoma . . . . . . . . . . . . 119
6.8.1 Pathology . . . . . . . . . . . . . . . . . . 119
6.8.2 Biology and Molecular Mechanisms . 121
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
7 B-Cell Lymphoma/Burkitt Lymphoma
I. Magrath
7.1 Introduction . . . . . . . . . . . . . . . . . . . . . 142
7.2 Diagnosis and Imaging . . . . . . . . . . . . . . 142
7. 2.1 Burkitt Lymphoma . . . . . . . . . . . . 142
7.7.2 Diff use Large B-cell Lymphoma . . . . 143
7.2.3 Burkitt-like Lymphoma . . . . . . . . . 144
7.2.4 HIV-Associated B-cell Lymphomas . . 144
7.2.5 Imaging Studies . . . . . . . . . . . . . . 144

7.3 Clinical Features . . . . . . . . . . . . . . . . . . . 146
7.4 Staging . . . . . . . . . . . . . . . . . . . . . . . . 148
7.4.1 Staging Procedures . . . . . . . . . . . . 150
7.5 Treatment . . . . . . . . . . . . . . . . . . . . . . 151
7.5.1 Early Studies in Africa . . . . . . . . . . 151
7.5.2 Non-Cross-Resistant Drugs and
Combination Therapy . . . . . . . . . . 152

7.5.3 Therapy Directed Towards
CNS Disease . . . . . . . . . . . . . . . . 154
7.5.4 Early Studies in the USA . . . . . . . . . 154
7.5.5 Comparison with Leukemia Treatment 155
7.5.6 Critical Components of Modern
Treatment Protocols . . . . . . . . . . . 155
7.5.6.1 Basic Drugs . . . . . . . . . . . . . . . 155
7.5.6.2 High-Dose MTX . . . . . . . . . . . . 156
7.5.6.3 The Role of Additional Drugs . . . 156
7.5.6.4 Dose Density . . . . . . . . . . . . . 157
7.5.6.5 Risk Adaptation . . . . . . . . . . . . 157
7.5.6.6 Prevention of CNS Disease . . . . . 159
7.5.6.7 Treatment of DLBCL with
Diff erent Regimens . . . . . . . . . . 160
7.5.6.8 Role of Surgery . . . . . . . . . . . . 160
7.5.6.9 Role of Radiation . . . . . . . . . . . 161
7.5.6.10 Tumor Lysis Syndrome . . . . . . . 162
7.6 Prognostic Factors . . . . . . . . . . . . . . . . . 163
7.6.1 Tumor Burden and Stage . . . . . . . . 163
7.6.2 Rapidity of Response . . . . . . . . . . . 164
7.6.3 Age and Sex . . . . . . . . . . . . . . . . 164
7.6.4 Histology . . . . . . . . . . . . . . . . . . 164
7.6.5 Molecular Characteristics . . . . . . . . 165
7.7 Outcome . . . . . . . . . . . . . . . . . . . . . . . 165
7.8 Management of Relapse . . . . . . . . . . . . . 166
7.9 Follicle Center Cell and Marginal Zone
Lymphomas . . . . . . . . . . . . . . . . . . . . . 167
7.10 Future Prospects . . . . . . . . . . . . . . . . . . 167
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

8 Anaplastic Large-Cell Lymphoma
A. Reiter
8.1 Introduction . . . . . . . . . . . . . . . . . . . . . 175
8.2 Diagnosis and Imaging . . . . . . . . . . . . . . 177
8.3 Clinical Features . . . . . . . . . . . . . . . . . . . 178
8.4 Staging . . . . . . . . . . . . . . . . . . . . . . . . 181
8.5 Treatment and Outcome . . . . . . . . . . . . . 181
8.5.1 Stratifi cation of Treatment Intensity . 185
8.5.2 CNS Prophylaxis and CNS Therapy . . 185
8.5.3 Role of Local Therapy Modalities and
Pattern of Therapy Failure . . . . . . . 186
8.6 Prognostic Factors . . . . . . . . . . . . . . . . . . . 187
8.7 Management of Relapse . . . . . . . . . . . . . . . 189
8.8 Future Prospects . . . . . . . . . . . . . . . . . . . . . 190
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

9 Precursor B and Precursor T-Cell Lym-
phoblastic Lymphoma

J.T. Sandlund
9.1 Introduction . . . . . . . . . . . . . . . . . . . . . 199
9.2 Diagnosis and Imaging . . . . . . . . . . . . . . 199
9.2.1 Diagnosis . . . . . . . . . . . . . . . . . . 199
9.2.2 Imaging/Staging . . . . . . . . . . . . . 201
9.3 Clinical Features . . . . . . . . . . . . . . . . . . . 202
9.4 Treatment . . . . . . . . . . . . . . . . . . . . . . . 202
9.4.1 Initial Management . . . . . . . . . . . 202
9.4.2 Treatment Overview . . . . . . . . . . . 203
9.4.2.1 Limited Stage Disease . . . . . . . . 203
9.4.2.2 Advanced Stage Disease . . . . . . 204
9.4.2.3 Central Nervous System
Prophylaxis and Treatment . . . . 205
9.5 Prognostic Factors . . . . . . . . . . . . . . . . . 208
9.6 Outcome . . . . . . . . . . . . . . . . . . . . . . . 208
9.7 Management of Relapse . . . . . . . . . . . . . 208
9.8 Future Prospects . . . . . . . . . . . . . . . . . . 208
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
10 Cutaneous T-Cell Lymphomas and Rare
T-Cell Non-Hodgkin Lymphomas
M.E. Kadin
10.1 Introduction . . . . . . . . . . . . . . . . . . . . . 215
10.2 Mycosis Fungoides and Sezary Syndrome . . 216
10.2.1 Clinical Features . . . . . . . . . . . . . . 216
10.2.2 Pathology . . . . . . . . . . . . . . . . . . 217
10.2.3 Immunophenotype . . . . . . . . . . . 218
10.2.4 Genetic Features . . . . . . . . . . . . . 218
10.2.5 Prognosis . . . . . . . . . . . . . . . . . . 219
10.2.6 Therapy . . . . . . . . . . . . . . . . . . . 220
10.3 CD30+ Cutaneous T-Cell Lymphomas
Including Lymphomatoid Papulosis . . . . . 221
10.4 Lymphomatoid Papulosis . . . . . . . . . . . . 221
10.4.1 Clinical Features . . . . . . . . . . . . . . 221
10.4.2 Pathology . . . . . . . . . . . . . . . . . . 222
10.4.3 Immunophenotype . . . . . . . . . . . . 223
10.4.4 Genetic Features . . . . . . . . . . . . . 223
10.4.5 Prognosis . . . . . . . . . . . . . . . . . . 223
10.5 Primary Cutaneous Anaplastic
Large-cell Lymphoma . . . . . . . . . . . . . . . 224
10.5.1 Clinical Features . . . . . . . . . . . . . . 224
10.5.2 Pathology . . . . . . . . . . . . . . . . . . 224
10.5.3 Diff erential Diagnosis . . . . . . . . . . 224
10.5.4 Immunophenotype . . . . . . . . . . . . 225
10.5.5 Genetic Features . . . . . . . . . . . . . 225
10.5.6 Therapy . . . . . . . . . . . . . . . . . . . 225

10.6 Subcutaneous Panniculitis-like
T-Cell Lymphoma . . . . . . . . . . . . . . . . . . 225
10.6.1 Clinical Features . . . . . . . . . . . . . . 226
10.6.2 Pathology . . . . . . . . . . . . . . . . . . 226
10.6.3 Immunophenotype . . . . . . . . . . . 226
10.6.4 Genetic Features . . . . . . . . . . . . . 227
10.6.5 Therapy . . . . . . . . . . . . . . . . . . . 227
10.7 Hepatosplenic T-Cell Lymphoma . . . . . . . 227
10.7.1 Clinical Features . . . . . . . . . . . . . . 227
10.7.2 Pathology . . . . . . . . . . . . . . . . . . 227
10.7.3 Immunophenotype . . . . . . . . . . . 227
10.7.4 Genetic Features . . . . . . . . . . . . . 227
10.7.5 Therapy . . . . . . . . . . . . . . . . . . . 228
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 228

11 Lymphoproliferative Disorders
Related to Immunodefi ciencies
T.G. Gross and B. Shiramizu
11.1 Introduction . . . . . . . . . . . . . . . . . . . . . 233
11.2 Epstein-Barr Virus . . . . . . . . . . . . . . . . . . 234
11.3 Post-transplant Lymphoproliferative
Disease . . . . . . . . . . . . . . . . . . . . . . . . 236
11.3.1 PTLD Following Blood or Marrow
Transplantation . . . . . . . . . . . . . . 239

11.3.2 PTLD Following Solid Organ
Transplantation . . . . . . . . . . . . . . 240
11.4 HIV-Related Malignancies . . . . . . . . . . . . 242
11.5 Lymphoproliferative Disease in Primary
Immunodefi ciencies . . . . . . . . . . . . . . . . 246
11.6 Summary . . . . . . . . . . . . . . . . . . . . . . . 250
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 250

12 Late Eff ects Following Lymphoma
Treatment
D.L. Friedman and A.T. Meadows
12.1 Introduction . . . . . . . . . . . . . . . . . . . . . 259
12.2 Second Malignant Neoplasms . . . . . . . . . 260
12.3 Neurocognitive . . . . . . . . . . . . . . . . . . . 261
12.4 Cardiovascular . . . . . . . . . . . . . . . . . . . . 261
12.5 Pulmonary . . . . . . . . . . . . . . . . . . . . . . 263
12.6 Bone and Body Composition . . . . . . . . . . 264
12.7 Endocrine . . . . . . . . . . . . . . . . . . . . . . . 264
12.7.1 Thyroid Gland . . . . . . . . . . . . . . . 264
12.8 Reproductive Endocrine . . . . . . . . . . . . . 265
12.8.1 Male Gonadal Function . . . . . . . . . 265
12.8.2 Female Gonadal Function . . . . . . . . 265
12.8.3 Reproduction . . . . . . . . . . . . . . . 266
12.9 Dental . . . . . . . . . . . . . . . . . . . . . . . . . 267
12.10 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . 267
12.11 Psychosocial . . . . . . . . . . . . . . . . . . . . . 268
12.12 Mortality . . . . . . . . . . . . . . . . . . . . . . . 268
12.13 Monitoring for Late Eff ects . . . . . . . . . . . 269
12.14 Research Challenges for Lymphoma
Survivors . . . . . . . . . . . . . . . . . . . . . . . 269
12.15 Future Directions . . . . . . . . . . . . . . . . . . 273
References . . . . . . . . . . . . . . . . . . . . . . . . . . . 274

Subject Index . . . . . . . . . . . . . . . . . . . . . . . 281

……………………………………………………………………………………………………………………………………………………………………………………………………………………

 

Medifit  Courses Demo Certificate 

48 hours delivery

| International acceptance | Medical based | Job oriented | Lifetime validity | Most economical |

 

555 INR Demo Certificate – 2 months duration

Demo Certificate – 6 months duration

48 hours delivery after fees payment

48 hours delivery after fees payment

 

Medifit 48 hours Delivery

  Get your Certificates delivered by online mode in 48 hours after Fees payment. We try to deliver certificates in 24 hours, but the committed delivery hours are 48. Its,

Pay Today &
get Tomorrow

procedure, only by Medifit.

LIFETIME VALIDITY

Medifit issues Lifetime validity certificates for all Online Courses provided. No need to renew the certificates every 2 or 3 years. All Courses Certificates of Medifit are having Lifetime Validity. No need to renew these certificates every 2 or 3 years.

 

What makes the certificates of Medifit to get it recognized Internationally?

Vast number of students applying for Job in international market of Fitness through Medifits Online Courses Certificates. And most importantly, the Medical standards maintained, helps to acquire jobs internationally. This gives very strong International acceptance to Certificates of Medifit Courses.

 

ABOUT MEDIFIT ACADEMY CERTIFICATION COURSE:

Medifit Education Online Academy is an innovative, digital and engaging education platform that delivers fast track accredited courses and skills development courses instantly online, with no time limits, enabling individuals to study anywhere and anytime. We are proud to offer international standard courses that have helped our students build their careers across the globe.

HOW DO MEDIFIT ONLINE CERTIFICATE COURSES HELP?

Short term Professional Courses International Standards courses Opens Global opportunities Career defining Courses Skill Development Programmes Knowledge in short span Learn at your own pace Certification of Completion Immediate Earning Opportunities Positive Social Impact Optimistic Psychological Benefits Improved Standard of Living Study from anywhere & anytime Very Economical Fees

Leave a Reply