Acute/Chronic Leukemia case studies Flashcards
What are age-related acquired genetic damage to hematopoietic cells that causes ineffective erythropoiesis?
Myelodysplastic Syndromes
How do Myelodysplastic Syndromes usually present?
Cytopenias and dismorphic blood cells
Anemia with macrocytosis
How do Myelodysplastic Syndromes usually present?
Cytopenias with dismorphic blood cells
Anemia with macrocytosis
Myelodysplastic Syndromes are precursors for?
Acute Myeloid Leukemia
Acute Myeloid Leukemia is defined as?
Greater than 20% myeloid blasts in the bone marrow
How do you calculate severe neutropenia (ANC)?
(%neutrophils + %bands) X WBC
ANC < 500 =
Severe Neutropenia
What can be seen with AML if there is a fever and severe neutropenia present?
Neutropenic fever
4 steps to confirming neutropenic fever?
- Physical exam and culture 2 sets of blood + 1 urine
- Chest X-ray
- Empiric antibiotics
- Start chemotherapy for AML
With empiric antibiotics, what type of bacteria should you treat first?
Gram NEGATIVE (ex. pseudomonas)
Empiric antibiotics to treat gram (-) infections
Cefepine
Piperacillin-tazobactum
Meropenem
Ceftazidine
What can you add to empiric antibiotics to treat MRSA
Vancomycin
If the neutropenic fever does not resolve in 48 hours after administering empiric antibiotics, what should you give?
Fungal coverage antibiotics (ex. candida)
Induction chemotherapy involves a 2 week hospital course stay. What is placed to administer chemo?
Central line
If after a central line is placed, a new fever arises, what should be cultured?
Central line
Initial chemo to induce remission
Induction chemo
Intense chemo to kill all cancer cells in the body
Consolidation chemo
Longer term chemo to maintain remission
Maintenance chemo