Devita, Hellman, and Rosenberg's Cancer

LWBK1006-30 LWW-Govindan-Review December 12, 2011 19:35

Chapter 30•Lymphomas 425

Question 30.45. All of the following statements about HL during pregnancy are true,

EXCEPT:

A. CT scanning is to be avoided because it exposes the fetus to ionizing

radiation. MRI may be used for staging because it is nonteratogenic.

B. Chemotherapy drugs that act as antimetabolites, such as methotrex-

ate, have a high risk of causing teratogenesis. The long-term survival

of women with HL who were pregnant at the time of initial presen-

tation is worse than that of nonpregnant women with similar stages

of disease.

C. In the second or third trimester of pregnancy, if there is rapid pro-

gression of supradiaphragmatic lymphadenopathy, RT alone can be

used. If involved field or mantle radiation is used with abdominal

shielding, the risk of adverse sequelae for the fetus is low.

D. If HL is diagnosed in the first trimester of pregnancy, therapeutic

options in early pregnancy are limited and include supradiaphrag-

matic irradiation or pregnancy termination. If the woman wants to

continue the pregnancy, treatment should be deferred until at least

the second trimester, if possible.

Question 30.46. Patients with HL develop treatment-related complications after curative

therapy for HL. All of the following statements such as secondary malig-

nancies are true, EXCEPT:

A. Secondary AML appears to be higher in patients treated with ABVD

regimen, compared with patients treated with MOPP.

B. Treatment-related AML has a latency period of 3 to 5 years, and most

cases occur within 10 years of the initial treatment.

C. Most cases of NHL occurring after HL have intermediate or high-

grade histology.

D. Solid tumors tend to occur in the second decade after therapy and

include lung cancer in smokers and breast cancer in women.

Question 30.47. All of the following statements about long-term complications in patients

with HL are true, EXCEPT:

A. Myocardial damage from radiation and anthracycline exposure can

be serious.

B. Lung fibrosis is not seen after exposure to RT plus bleomycin or

BCNU-based high-dose therapy (i.e., BEAM or BEC)/autologous

SCT.

C. Hypothyroidism after mantle RT can be detected by finding an ele-

vated thyroid-stimulating hormone level.

D. The risk of postsplenectomy sepsis can be minimized by immuniza-

tion with pneumococcal vaccine; vaccines have also been developed

against Neisseria and Haemophilus, which are also associated with

postsplenectomy sepsis.