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NON-HODGKIN’S
LYMPHOMA
B cell malignancies
Classification:
Classical Hodgkin’s
Nodular sclerosis – low grade
Mixed cellularity
Lymphocyte rich classical 1798-1866
Lymphocyte depleted. – high grade
I Involvement of a single lymph node region (I) or of a single extralymphatic organ or site
(IE)
II Involvement of two or more lymph node regions on the same side of the diaphragm (II)
or localized involvement of an extralymphatic organ or site and one or more lymph node
regions on the same side of the diaphragm (II E)
III Involvement of lymph node regions on both sides of the diaphragm (III) which may be
accompanied by involvement of the spleen (III S) or by localized involvement of an
extralymphatic organ or site (III E) or both (IIISE)
B symptoms: fever > 38ºC for three consecutive days, drenching night sweats or unexplained loss 10% or more of
weight the preceding 6 months
Hodgkin’s Disease/Lymphoma
Treatment
Unfavorable prognostic factors:
- Stage IIIB, IV
- B symptoms
- Bulky disease
- High ESR >50
Hodgkin’s Disease/Lymphoma
Treatment
Adolescent patients who have achieved
maximum growth can be treated as adult
patients
Combination chemotherapy
ABVD 80% RC
BEACOPP 90% RC
Limfoma non Hodgkin merupakan
sekelompok keganasan yang berasal
dari sistem kelenjar getah bening,
yang biasanya menyebar ke seluruh
tubuh.
Diagnosis limfoma non Hodgkin
ditegakkan berdasarkan konfirmasi
patologis melalui pemeriksaan biopsi
jaringan
Patogenesis terjadinya limfoma non Hodgkin adalah
translokasi kromosom dan perubahan molekuler,
seperti t(14;18)(q32;q21), t(11;14)(q13;q32), dan
lainnya.
Beberapa virus mempengaruhi patogenesis
terjadinya limfoma non Hodgkin, oleh karena
kemampuan mereka untuk menginduksi stimulasi
antigen dan disregulasi sitokin, yang akhirnya
menyebabkan stimulasi, proliferasi, dan
limfomagenesis sel B dan sel T yang tak terkontrol.
Virus-virus ini antara lain yaitu virus Epstein Barr,
hepatitis C, human T cell leukemia virus type 1 (HTLV-
1).
NHL: Inseden 5x lbh sering dari pada HL
Laki-laki >> wanita
Rata-rata usia 42 th-an
Aggressive lymphoma merupakan limfoid
yang paling sering ditemukan.
Non-Hodgkin’s Lymphoma
Rappaport Classification
Nodular (follicular) Diffuse
Indolent Aggressive
Composite
lymphomas (13%)
Diffuse large
Armitage et al. J Clin Oncol. 1998;16:2780–
B-cell (31%)
2795
Burkitt’s Lymhoma
Starry, Starry Night
Non-Hodgkin’s Lymphoma
Lymphoblastic NHL
Very aggressive
Treatment is with acute lymphocytic
leukemia regimen
Often requires high-dose therapy and
allogeneic transplantation for
relapsed/refractory disease
Gamma Delta-T-cell NHL
Lab :
Hematologi: Anemia, eosinofilia, LED naik
Flow cytometry: detelsi limfosit abnormal
LFT, RFT,hiperurecemia, LDH, FOTO THORAX,
USG ABD
Monoclonal Abs - Rituxan
Klasifikasi
Leukemia Akut:
Leukemia Mieloblastik Akut : Berdasarkan FAB:
Mo : Leukemia Mieloblastik Akut tanpa maturasi
M1 : LMA dengan maturasi minimal
M2: LMA dengan maturasi
M3: Leukemia Promielositik Akut
M4 : Leukemia Mielomonositik Akut
M5a: Leukemia Mielomonoblastik akut tanpa
diferensiasi
M5b: LMMA dengan diferensiasi
M6: Eritroleukemia Akut
M7: Leukemia Megakariositik
Leukemia Limfositik Akut: berdasarkan asal
sel limfoid:
Early pre B cell ALL
Pre B cell ALL
B cell ALL
T cell ALL