Unit 23 Altered Cell Proliferation Leukemia, Lymphoma, Hospice Flashcards
How is Leukemia classified?
What are the two types?
Classified by the cell line:
-Myeloid and Lymphoid
Lymphoid makes T, B, K cells
Myeloid makes everything else (platelets, RBCs, WBC’s etc)
What is Polycythemia?
What are the symptoms?
What is the tx?
What are PT’s at risk for?
Increased RBCs
- Hct > 55%
- Ruddy complexion
- Headache
- Vision problems
- Weight loss
- Enlarged spleen***
Tx:
- Phlebotomy (blood letting, donating blood)
- ASA (to prevent clots)
- hydroxurea (a metabolite Rx)
- Avoid iron
PT’s at risk for Stroke, DVT
What is Myelodysplastic Syndrome? What can it progress to? What are the symptoms? What are the risk factors? What is the treatment?
Immature blood cells that don’t mature (they die young)
Typical onset is 70 years old
-Can progress to Myeloid Leukemia
Symptoms:
- Decreased RBCs, WBCs, Platelets
- Fatigue
- Frequent infections
Risk factors:
- Chemo
- Radiation
- benzene
- pesticides
- lead or mercury exposure
Tx:
-Supportive treatment
Describe Leukemia.
Literally “White Blood”
- Malignant disorder affecting the blood and tissue of the bone marrow, lymph system, and spleen.
- Unregulated proliferation and excessive accumulation of leukocytes (WBCs) in the bone marrow
- Results in overcrowding in bone marrow of WBC’s
- Increased WBC’s that are useless, RBCs normal but useless
What are the types of Leukemia? Describe.
Acute vs Chronic, Myeloid vs Lymphoid
Acute:
-Onset abrupt and immature cells
Chronic
- Slow onset
- More mature cells
- Acute Myeloid
- Chronic Myeloid
- Acute Lymphoid
- Chronic Lymphoid
What is Acute Myeloid Leukemia.
What are the risk factors?
What are the symptoms?
What is the treatment?
- Onset abrupt and immature cells w/ excessive proliferation
- Incidence peaks at age 60, but also affects children.
- Very ill, hospitalized for weeks
Risk factors:
- Radiation
- Benzene
- Chemo
- Down’s Syndrome**
Symptoms:
- Anemia
- Infection
- Thrombocytopenia (DIC)
Tx:
-Induction therapy: aggressive chemo to kill myeloid cells, results in low to no cell counts (thrombocytopenia)
- Followed by Consolidation therapy (radiation or Rx to kill off remaining cells)
- Bone marrow Transplant/peripheral blood stem cell transplantation (goes into vein)
What can result from the Induction Therapy treatment for Acute Myeloid Leukemia?
Describe, and what is the treatment?
Tumor Lysis Syndrome:
-Cells are being destroyed releasing uric acid
Tx: allopurinol and fluid
What is Chronic Myeloid Leukemia? What is specific to this illness? What is the risk factor? What are the symptoms? What is the medication/treatment?
- Excessive development of mature neutrophils
- Peak age 45
-Philadelphia chromosome specific
Risk Factor: Radiation
Symptoms: they develop slowly*
- Weakness
- Fatigue
- Weight loss
- WBCs 100,000!!
- Some PT’s Asymptomatic
Tx:
-imatinib mesylate
What is Thrombocytopenia?
low platelet count
Describe Acute Lymphocytic Leukemia.
What is a risk factor?
What are the symptoms?
What is the treatment?
- Most common type of leukemia in children.
- PT’s will ALL tend to have better response to treatment than do PT’s with AML.
- High remission rate! :)
Risk factor: Radiation
Symptoms:
- Leukocyte count high or low, but always high amount immature cells
- Organ infiltration = hepatosplenomegaly, bone pain, headache, and vomiting
Rx/Tx:
- steroids*
- imatinib*
- methotrexate
- intrathecal chemo
- Ommaya reservoir (implanted into ventricle to deliver medications)
What are the donor types of bone marrow transplant?
Allogenic (needs HLA matching)
Autologous
Syngeneic (identical twin of PT)
What is Graft vs Host complication from bone marrow transplants?
New cells of Donor attack PT
What is Chronic Lymphocytic Leukemia?
Describe.
Symptoms?
Treatment?
Malignant form of B lymphocytes
- Age 50-70
- Very few risk factors
- Most common form of Leukemia.
Sx:
-lymphadenopathy, unusually VERY large glands from Immune response
Tx:
- If early dx = no treatment
- chemo
- corticosteroids
- monoclonal antibody therapy w/ rituximab
What are Lymphomas?
Enlarged cancer filled lymph nodes
What does lymphatic system do?
Contains lymphocytes that eliminate bacteria
Antibodies manufactured by the lymph system
