Working formulation grade intermediate grade high

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Unformatted text preview: diate grade High grade Classification Low grade Proliferation: Course: Symptoms: Treatment: Low Indolent -ve Not curable High grade High Rapid, fatal(un-Rx) +ve Potentially Curable Etiology Cannot be attributed a single cause Chromosomal translocations: (14, 18) Infection: Virus:EBV, t HTLV,HHV-8, HIV Bacteria: H.Pylori - Gastric lymphoma Immunology: Congenital immunodeficiency, Immunocompromised patients - HIV, organ transplantation Management Low grade: Asymptomatic Radiotherapy : No treatment ; for localised disease (Stage 1); Chemotherapy: mainstay is Chlorambucil; Initial response good , but repeated relapses, median survival 6-10 yrs; Newer: Fludarabine, 2-CdA (Chlorodeoxyadenosine) Monoclonal SCT/BMT antibody: Rituximab Aggressive ( high / intermediate grade): Chemotherapy: mainstay CHOP -every 3 weeks, at least 6 cycles Cyclophosphamide, Doxorubicin Hydrochloride, Vincristine, Prednisolone High risk cases with poor prognostic factors or relapse : High dose chemotherapy combined with autologous BMT / SCT antibody Monoclonal With CNS involvement / leukemic relapse : Similar to ALL Prognosis Low grade : Median survival 10 yrs High Grade: Increasing age, advanced stage, concomitant disease, raised LDH,T- cell phenotype : Poor prognosis...
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