T11: Leukemia Flashcards
leukemia
“blood cancer” a group of malignant disorders affecting the blood and blood-forming tissues of bone marrow, lymph system, spleen; accumulation of dysfunctional cells due to loss of regulation in cell division; WHITE BLOOD CELL PROBLEM (immature and non-functioning)
normal WBC
5,000-10,000
leukemia has ischemia (aches and pain) because…
there are too many WBCs in circulation
acute
clonal proliferation of IMMATURE HEMATOPOIETIC CELLS
chronic
mature forms of WBC and onset is more gradual
Acute lymphocytic leukemia (ALL)- Based on type of WBC
Lymphocytes-viral
Acute myelogenous leukemia (AML) Based on type of WBC
Neutrophils-bacterial
Acute Myelogenous Leukemia (AML)
Abrupt, dramatic onset with serious infection or abnormal bleeding
o BRUISING, gums bleed while brushing teeth, blood in urine
Uncontrolled proliferation of myeloblasts; hyperplasia of bone marrow and spleen
most common type of leukemia in children
Acute lymphocytic leukemia (ALL)
clinical manifestations of acute lymphocytic leukemia
o Abruptly: Fever, Bleeding. bruising
§ Fever of unknown origin
o Insidiously: Progressive weakness, fatigue, pain, bleeding tendencies
- Kid is super tired and lethargic
o CNS: Leukemic Meninigitisarachnoid infiltration
Chronic Myelogenous Leukemia (CML)
excessive mature neoplastic granulocytes in bone marrow; move into peripheral blood in massive numbers, ultimately infiltrating liver and spleen
diagnostic for Chronic Myelogenous Leukemia (CML)
HINT HINT: Philadelphia chromosome
most common leukemia in adults
chronic lymphocytic leukemia (CLL)
leukemia clinical manifestations: ANT
Anemia, Neutropenia, Thrombocytopenia
Leukemic white cell count in the peripheral blood
> 100,000/µL
Leukemic white cell count in the peripheral blood is >100,000/µL and causes
o a high leukemic WBC count in peripheral blood
o Blood thickens and blocks circulatory pathways
- PAIN BECAUSE OF CLOTS, MAKE SURE THEY AREN’T INFARCTING OTHER ORGANS
complete remission
: no evidence of overt disease is found on physical examination, and the bone marrow and peripheral blood appear normal.
partial remission
is characterized by lack of symptoms and a normal peripheral blood smear, but evidence of disease is still seen in the bone marrow.
Minimal residual disease
is defined as tumor cells that cannot be detected by morphologic examination but can be identified by molecular testing.
molecular remission
indicates that all molecular studies are negative for residual leukemia.
Stages of chemotherapy
o 1. Induction-nursing interventions focus on neutropenia, thrombocytopenia, and anemia
o 2. Postinduction or postremission (consolidation)-intensification-HIGH DOSE-after remission
o 3. Maintenance-every 3-4 weeks, keep free of leukemic cells
SE OF CHEMOTHERAPY
o Neutropenia: Neutropenic precautions
o Nausea:
- Medications, do not take in strong-smelling food cauliflower, broccoli, onions, etc
- IV fluids and watch electrolytes
nadar
10-14 days after administration of chemo their WBC are NON-EXISTENT
o Check WBC on day 10, they are profoundly neutropenic
for bone marrow transplant you need a…
HLA MATCH AND GET BONE MARROW FROM PELVIC GIRDLE
HEMATOPOIETIC STEM CELL TRANSPLANT
Þ THIS IS A CURE IF THEY GET ALL THE BAD CELLS
Erythropoietin (Epogen)
boosts health RBC in the patient FOR ANEMIA OF CHRONIC CANCER
SE of Erythropoietin (Epogen)
hypertension, thrombosis, headache
Granulocyte colony-stimulating factor (G-CSF): Filgrastim (Neupogen)
boost healthy WBC in patient FOR CHEMOTHERAPY-INDUCED NEUTROPENIA
SE of Granulocyte colony-stimulating factor (G-CSF): Filgrastim (Neupogen)
o bone pain, N/V
Interleukin-11 (platelet growth factor):
FOR THROMBOCYTOPENIA RELATED TO CHEMOTHERAPY
SE of Interleukin-11 (platelet growth factor):
fluid retention, peripheral edema, dyspnea, tachycardia, nausea, mouth sores
