Neoplastic Hematological Disorders Flashcards
Uncontrolled growth of abnormal cells in the body
Cancer
type of cancer that affects the blood and bone marrow
Leukemia
“Leuk” -white
“Emia” -condition of the blood
2 types of Leukemia Cancer
- Acute
- Chronic
- RAPID replication of immature WBCs that have developed a malignancy
- May develop symptoms within weeks
- Without warning
Acute Leukemia
- involves more mature WBCs
- disease onset is more gradual, may go years without symptoms
Chronic Leukemia
1st type of Leukemia:
Myeloid leukemia (an abnormal growth of the myeloid stem cell- turns into any cell except lymphocyte) is primarily classified into 2 main types
- Acute Myeloid Leukemia (AML)
- Chronic Myeloid Leukemia (CML)
Acute Myeloid Leukemia (AML):
The S/S result from insufficient production of
normal BLOOD cells in bone marrow
(includes RBCs, WBCs, Platelets)
S/S of Acute Myeloid Leukemia (AML)
- Fever and infection
- Weakness, fatigue, dyspnea on exertion, pallor
- Petechiae, ecchymoses (bruising), bleeding tendencies
What age category is affected by AML?
adults
3 Diagnostics for Acute Myeloid Leukemia (AML)
- Physicall assessment
- CBC
- Bone Marrow Biopsy **
What cells are found in the Bone Marrow Biopsy that are the HALLMARK to AML?
BLAST cells
(immature leukocytes)
Acute Myeloid Leukemia (AML) Physical Findings
List 4
- Abdominal Pain
- Bone Pain
- Gingival infiltration- leukemic cells in gum
- Leukemia cutis- leukemic cells in skin
How to treat Acute Myeloid Leukemia (AML)
- Chemotherapy 2 stages only
a. Induction chemotherapy: initial phase- very agressive
b. Consolidation chemotherapy: aims at killing remaining leukemic cells- lower doses - HSCT
- Medical procedure where damaged or unhealthy blood cells in a patient’s body are replaced with healthy stem cells.
- These stem cells can come from the patient themselves or from a donor.
Hematopoietic stem cell transplantation (HSCT)
Hematopoietic
- process of blood cell formation.
- production and development of various types of blood cells (RBC, WBC, and platelets) primarily in the bone marrow.
What are the 3 sources for stem cells.
- bone marrow
- peripheral blood
- umbilical cord blood
What are the 2 main complications for HSCT
- Infection
- Graft-Versus-Host Disease (GVHD) **
know
Graft-Versus-Host Disease (GVHD) attacks 3 main organs.
- Skin
- GI tract
- Liver
After Acute Myeloid Leukemia (AML) treatment what are 2 major complications?
- Disseminated intravascular coagulation (DIC)
- Tumor lysis syndrome
What happens in Disseminated intravascular coagulation (DIC)
- Widespread activation of the clotting process in the blood vessels
- Excessive clotting – massive amounts of tiny clots
- Causes organ failure from ischemia (decr blood flow)
Disseminated intravascular coagulation (DIC):
Once body is no longer able to clott, the patient is at risk for
excessive bleeding
What occurs in TUMOR LYSIS SYNDROME
- Massive leukemic cell destruction from chemotherapy
- Lysed cells release toxins and fluids into blood circulation
What 3 substances increase in Tumor Lysis Syndrome?
- uric acid
- potassium
- phosphate
when K+ increases- calcium decreases
know
- Type of cancer that affects the blood and bone marrow.
- It is characterized by the overproduction/mutation of myeloid cells- (type of WBC involved in the immune response)
Chronic Myeloid Leukemia (CML)
What is the HALLMARK genetic abnormality of Chronic Myeloid Leukemia (CML)?
Philadelphia (Ph+) chromosome
3 Clinical Manifestations for Chronic Myeloid Leukemia (CML)
- Might have no symptoms
- elevated WBC count detected on routine CBC
- May develop into acute phase
Patient with extremely HIGH leukocyte counts will show
- Shortness of breath
- Enlarged, tender spleen
- Occasional enlarged liver
- Anorexia, weight loss
2 Main Medical Managements for CML
- Tyrosinase Kinase Inhibitors (TKIs) -medications **
- Hematopoietic Stem Cell Transplant (HCST)
(Treatments go in this order also- start with TKIs first)
What do * Tyrosinase Kinase Inhibitors (TKIs) do?
- Decreased the need for stem cell transplant
- Targets the BRC-ABL protein that causes the cancer cells to grow
- Attacks cancer cells without harming normal cells **
In Chronic Myeloid Leukemia- Hematopoietic Stem Cell Transplant (HCST) treatment will only be used in patients less than ___ years of age.
65 years of age