Hematology Jeopardy

Lymphoma

100

These are the stages of lymphoma (Describe each stage)

• Stage 1 lymphoma – Cancer is found in one lymph node, a lymphoid organ such as the thymus or one area of a single organ outside of the lymphatic system.
• Stage 2 lymphoma – Cancer is found in two lymph nodes (both on the same side of the diaphragm) or extends from one lymph node into a nearby organ.
• Stage 3 lymphoma – Cancer is found in several lymph nodes, both above and below the diaphragm, and may also have spread to the spleen.
• Stage 4 lymphoma – Cancer is found outside of the lymphatic system or in two or more distant organs such as the liver or the lungs.

200

One should always test for this lab test upon diagnosing Splenic Marginal Zone Lymphoma

Hepatitis C

300

This is the most favorable prognostic cytogenetic for CLL

What is 13q?

Trisomy 12 is normal prognosis

ZAP 70 are 17P are some bad prognoses

400

This is the Rai Classification of staging for CLL

 Stage 0: Lymphocytosis only (ALC > 5000/mcl) 

Stage I:  Lymphocytosis with lymphadenopathy

 Stage II: Lymphocytosis with hepatosplenomegaly 

Stage III: Lymphocytosis with anemia (Hb <11 g/dl) 

Stage IV: Lymphocytosis with thrombocytopenia (Plt <100,000/mcl) 

500

This stain is positive in Mantle Cell, though negative in CLL

What is Cyclin D? 

CD20 is weak in CLL, and strong in Mantle Cell

CD23 and CD5 are also positive in CLL, but not Mantle Cell

MDS

100

This is the risk stratification needed to stratify each MDS case

What is IPSS or R-IPSS? This includes cytogenetics, medullary blasts, Hemoglobin, platelets, and ANC

200

Deficiency which nutritional supplement can cause dysplasia in the marrow

What is Copper?

300

This is the treatment indicated for MDS with ringed sideroblasts?

Luspatercept

400

These are the bad cytogenetic abnormalities of MDS?

Abnormal 3q, -7, double/multiple abnormality, complex with 3 abnormalities

500

These are the good cytogenetic abnormalities of MDS

What are del5q, del11q (VG), del12p, del20q, -Y (VG)?

Multiple Myeloma

100

This is the SLIM CRAB Criteria

S = greater than or equal to sixty percent clonal plasma cells in the bone marrow 

Li = involved/uninvolved free light chain ratio of 100 or more with the involved FLC being greater than or equal 100 mg/L

M = MRI 

C = increased calcium levels (greater than 11.5 mg/dL

R = renal insufficiency (creatinine greater than 2 mg/dL or creatinine clearance less than 40 mL/min

A = anemia (hemoglobin less than  10 g/dL or 2 g/dL less than  normal

B = presence of bone lesions ( presence of one or more osteolytic lesions seen on skeletal radiography, whole-body MRI, or whole-body FDG PET/CT )

200

These are the high the risk features for MGUS

M spike > 1.5, Non-IgG M protein, abnormal light chain protein < 0.26 and >1.6

Otherwise 1% risk of progression to myeloma per year

300

T/F 11;14 is a good prognostic marker for multiple myeloma

True

Good prognostic markers are  t(11;14); (6;14) and trisomies

High yield BAD Prognosis 14;16; 4;14; and 14;20 are bad prognostic markers (all multiples of 4)

400

These are the high risk features for smoldering myeloma

What is the 2-20-20 rule? 

M Spike greater than 2, 20% plasma cells, K/L > 20

10% progression per year, after 5 years (if you make it past 5 year mark, drops to 3%)

500

This constitutes progressive disease in Multiple Myeloma.

What is 25% increase in M protein, FLC or plasma cell percent or new bone lesions

Poutpourie

100

The is the level of EPO which you should start EPO in MDS

EPO < 500

200

5Q deletion Multiple Myeloma responds to which treatment?

Lenolidamide

300

TRAP positivity îș seen in which malignancy?

Hairy Cell Leukemia

400

HLH is a disorder that involves dysfunction of these cell types

What are NK and cytotoxic T cells?

500

These are the CART cells approved for multiple myeloma

Ide-cel and Cilta cel 

Approved following 4 previous lines of therapy, following immunotherapy, CD38 monoclonal inhibitor, proteasome inhibitor

Pharmacology

100

This is the MOA of acalabrutiinb  

BTK inhibitor

200

What lab/screening test do you need to get before daratumumab?

Type and Screen

300

This medication is needed for prophylactic reasons while on bortezomib

Valcyclovir/shingles prophylaxis

400

Alemtuzumab targets which CD?

CD52

Needs to be on PCP/herpes prophylaxis!

500

This is target of Elotuzumab 

Monoclonal antibody against SLAMF7