13.2 Leukemia and Brain Tumors

Question 1

Leukemia

Answer 1

• Most common pediatric cancer
• Malignancy of bone marrow and lymphatic system. Unrestricted proliferation of immature WBC’s (non-functional).
• Leukemia depresses the bone marrow which leads to anemia (destroyed RBCs), infection (neutropenia) and bleeding from low platelets.

Classification
- Type of WBC that is being impacted (neoplastic) and what stage the cell is in.

ALL - Acute Lymphoid Leukemia
- Increased production of immature lymphoblasts and WBCs

AML - Acute Myeloid Leukemia
- Typically in ages under 2 or adolescents
- Increased production of immature WBC’s that does not include lymphoblasts.

Question 2

ALL Clinical Manifestations

Answer 2

• Infiltration of immature lymphoblasts (nonfunctional)
• Typically affects highly vascular organs such as liver, spleen, lymph nodes, and reproductive tract (testes, ovaries, prostate), lungs, and CNS.

Symptoms
- Unexplained fever
- Bleeding/bruising
- Bone pain and Joint pain
- Enlarged lymph nodes
- Hepatosplenomegaly
- Lethargy/Fatigue/Malaise/Pallor
- Anorexia
- Limp/Refusal to Walk
- Inability to move eye to the side

Question 3

Chemotherapy for ALL

Answer 3

Induction Phase
- To kill the leukemia cells in the blood and bone marrow to put the disease into remission

Consolidation/Intensification Phase
- Trying to rid the body of any remaining cells that may cause leukemia to return
- Occurs after remission is confirmed

Maintenance Phase
- Destroy any cancer cells that may have survived the first 2 phases
- This is to keep a patient in remission long term.

Question 4

Brain Tumors

Answer 4

• Most common solid tumor in pediatrics (second most common to leukemia)
• Usually occur below the roof of the cerebellum and involve cerebellum, mid brain and brain stem.
• Cause is unknown but may be genetic

Question 5

Brain Tumor Manifestation

Answer 5

• Headache (most common)
• N/V (most common)
• Abnormal Gait
• Dizziness
• Change in vision/hearing
• Fatigue
• Mental Status Change (educational or behavioral problems)

Brain Stem Tumors (growth failure)
- Weight deficits
- FTT (failure to thrive) in infancy/childhood