LWBK1006-30 LWW-Govindan-Review December 12, 2011 19:35
Chapter 30•Lymphomas 417Question 30.20. All of the following apply to MCL, EXCEPT:
A. t(11;14)(q13;q32) is seen in MCL, along with cyclin D1 overexpres-
sion.
B. Bortezomib and temsirolimus have not shown activity in MCL.
C. MCL accounts for 7% of adult NHL in the United States and Europe,
and most patients present in stage IV disease (70%).
D. Hyper-CVAD+rituximab and/or clinical trials incorporating autol-
ogous or allogeneic stem cell transplantation with or without borte-
zomib maintenance should be considered in MCL in younger patients.Question 30.21. All of the following are true about MCL, EXCEPT:
A. Tumor cells strongly express sIgM and IgD (often of lambda light
chain type) and B-cell–associated antigens, and arises from antigen-
na ̈ıve B cells of the inner mantle zone.
B. Genetic abnormalities in addition tot(11;14) are uncommon.
C. Nuclear cyclin D1 protein is present in all cases and is the gold stan-
dard for the diagnosis.
D. More common in males.Question 30.22. All of the following are true of DLBCL, EXCEPT:
A. It is the most common lymphoma (31% in REAL series); patients
often have rapidly enlarging nodal masses and B symptoms. Up to
40% of DLBCLs are extranodal, and marrow involvement is seen in
16%.
B. At least two subtypes have been defined by gene expression profiling
(GEP), germinal center B cell (GCB), and activated B cell (ABC). GCB
survival is better than ABC survival and has thet(11;14)(q32;q21)
translocation, supporting the hypothesis that this DLBCL subtype is
of follicular cell origin.
C. GCB and ABC DLBCL subtypes cannot be differentiated by immuno-
chemistry.
D. Known subtypes of DLBCL include T-cell–rich B histiocyte cell vari-
ant, plasmablastic type seen in HIV-positive patients, and a rare ALK-
positive variant.Question 30.23. Regarding DLBCL, which of the following statements is NOT correct?
A. Abbreviated CHOP chemotherapy plus involved field RT is excellent
therapy for patients with low-risk, nonbulky, early-stage DLBCL.
B. Standard initial treatment of advanced-stage DLBCL is CHOP plus
rituximab; ongoing clinical trials are focusing on the role of upfront
autologous stem cell transplantation in patients with high IPI.
C. In a subset analysis of the GELA R-CHOP trial, rituximab appeared
to confer greater benefit in patients with DLBCL who do not express
bcl2 on immunocytochemistry.
D. Autologous stem cell transplantation is the treatment of choice for
patients with relapsed DLBCL that is shown to be chemosensitive.