Chapter 29: The Child With Cancer Video Flashcards
ANC absolute neutrophil count
1. Determine the total percentage of neutrophils
2. Multiply white blood cells count by percentage of neutrophils
Examples
WBC =1000/mm^3
Neutrophils = 7%
Nonsegmented neutrophils (bands) = 7%
Step 1: 7% + 7% = 14%
Step 2 : 0.14 x 1000 = 140/mm^3 ANC
This tells us how likely the patient is to develop an infection
If a child spits out the chemotherapy drug
That is considered a splash and puts you at risk
So watch out and wear PPE
Umbilical cord blood stem cell transplantation
Rich source of hematopoeitic stem cells for use in children with cancers
Stem cells are found with high frequency in circulation of newborns
Benefit of umbilical cord blood is the blood relative immunodeficiency at birth, allowing for partially matched unrelated cord blood transplants to be successful
Peripheral stem cell transplantation
A type of autologous transplant
Different type of collect from the patient
Stimulate the production of a high number of stem cells and then collect stem cell by an apheresis machine
Stem cells are seperate from whole blood, the remaining blood cells and plasma and returned to the patient after apheresis
Stem cells are frozen for later transfusion to the patient
What are the 4 risk factors of HSCT?
Significant risk of morbitiy & mortality
Graft versus host disease
Overwhelming infection
Severe organ damage
What is graft verses host disease?
The patient has bone marrow transplant, and when the patients body recognize these blood cells aren’t there’s, it’s gonna start to attack it
Meaning they are attacking it self’s
Transfusion reactions
Hemolytic reaction is the most severe but rare
ABO incompatibility is the most common
Febrile reactions ( fever, chills )
Allergic reactions
( urticaria, pruritus, laryngeal edema )
Air emobil may occur when blood is transfused under pressure
Hypothermia
Electrolye distribustances
Hyperkalcemia
- monitor with large amount of blood, renal impairment
Transmission of infection
- hepatitis, HIV, malaria, syphilis, others
- blood banks tests for infection vigorously and discard units of infected blood
Delayed hemolytic reaction
- destruction of RBCs, fever 5-10 days after transfusion
- observe for post-transfusion anemia
Brain tumors
Brain tumors can occur two ways, which are and means?
Infratentorial - posterior of head
( cerebellum or brainsteam 60% )
Supratentorial - anterior of the head
( cerebrum 40% )
Brain tumors and neuroblastoma are derived from what?
Neural tissues
Notes
Account for approximately 20% of childhood cancers
Tumors are difficult to treat and survival rates are poor
What is the diagnostic evaluation of a brain tumor?
Signs and symptoms are related to the anatomic location and size of the tumor and child’s age
Clinical signs
Neurologic evaluation
MRI, CT, EEG, angiography, lumbar puncture
Tissue specimens 100% answer
What is the treatment of brain tumors ?
Surgery
Chemo
Radiotherapy
