LWBK1006-30 LWW-Govindan-Review December 12, 2011 19:35
428 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology ReviewANSWERS
Answer 30.1. The answer is D.
Patients aged less than 30 years are eligible for treatment in pediatric
clinical trials. Many findings and methods first shown to be useful in
pediatric oncology (including the clinical trial mechanism itself) have been
successfully applied to adult oncology.Answer 30.2. The answer is A.
The classic translocations in Burkitt’s lymphoma aret(2;8),t(8;14), and
t(8;22). The translocationt(1;14) may be seen in MALT lymphoma.Answer 30.3. The answer is C.
Patients with trisomy 21, Down syndrome, have a higher risk for ALL
up to age 13 years, but not in the neonatal period. Extra copies of chro-
mosome 21 are a common finding but carry no prognostic meaning. In
neonates, a transient myeloproliferative disease is seen that resolves spon-
taneously. AML M7 develops in patients with Down syndrome aged less
than 2 years and is associated with GATA-1 mutations.Answer 30.4. The answer is D.
HIV infection is an acquired infection and is associated with increased
secondary lymphomas possibly related to EBV infection and a low CD4
count. Common variable immunodeficiency is also a risk factor, but its
cause is not known and may be a function of environmental exposure
and genetic predisposition.Answer 30.5. The answer is B.
ALK, is detected in more than half of the patients, is more common in
children and is associated with better prognosis.Answer 30.6. The answer is C.
According to the Non-Hodgkin’s Lymphoma Classification Project, small
lymphocytic lymphoma/chronic lymphocytic leukemia is the lymphoma
subtype most commonly associated with stage IV at diagnosis (83%),
followed by MCL (71%) and peripheral T-cell lymphoma (65%).Answer 30.7. The answer is C.
The largest NHL increase is in patients with aggressive histologies. In
primary CNS lymphoma, diffuse large B-cell NHL occurs increasingly in
patients with AIDS. Adult T-cell leukemia/lymphoma (ATL) is common
in Southern Japan and the Caribbean, whereas certain small intestinal
lymphomas are commonly seen in the Middle East.