Unit 8 - Leukemia Flashcards
Definition:
Body produces large number of abnormal blood cells/usually white blood cells
Leukemia
leukemia cells usually look _____ than normal blood cells and do not function properly
- often are _____ blasts that cannot grow into healthy blood cells
different
immature
Malignant WBCs fill bone marrow, replacing _____ _____ that produce _____, other blood products -> _____ decrease amount of these products in circulation
stem cells
RBCs
decrease
Leukemia diagnosed _____ times more often in adults than children
10
_____ are affected more than _____ with leukemia
men are affected more than women
Classified by acuity an predominant cell type involved:
- acute onset
- rapid disease progression
- immature, undifferentiated blast cells
acute leukemia
Classified by acuity an predominant cell type involved:
- gradual onset
- prolonged course
- abnormal mature-appearing cells
chronic leukemias
Classified by acuity an predominant cell type involved:
- involve immature lymphocytes and precursor cells in bone marrow
- infiltrate spleen, lymph nodes, CNS
lymphocytic leukemias
Classified by acuity an predominant cell type involved:
- involve myeloid stem cells in bone marrow
- interfere with maturation of all types of cells
myeloid leukemias
acute leukemia
- _____ onset
- _____ disease progression
- immature, undifferentiated _____ _____
- acute onset
- rapid disease progression
- immature, undifferentiated blast cells
chronic leukemias
- _____ onset
- _____ course
- _____ mature-appearing cells
- gradual onset
- prolonged course
- abnormal mature-appearing cells
lymphocytic leukemias
- involve immature _____ and _____ cells in bone marrow
- _____ spleen, lymph nodes, CNS
- involve immature lymphocytes and precursor cells in bone marrow
- infiltrate spleen, lymph nodes, CNS
myeloid leukemias
- involve _____ _____ _____ in bone marrow
- interfere with _____ of all types of cells
- involve myeloid stem cells in bone marrow
- interfere with maturation of all types of cells
Most common type of leukemia in children
acute lymphocytic leukemia
Most common type of leukemia in adults
acute myeloid leukemia
The top causes of cancer death in children and adolescents are _____ and other nervous system tumors and _____. The reason leukemia has a higher death rate in adolescents than in children, despite having a lower incidence rate, is because survival rates for leukemia are higher in _____ than _____.
brain
leukemia
children
adolescents
A defect in stem cell that differentiate into all myeloid cells: monocytes, granulocytes, erythrocytes, and platelets
AML
Most common nonlymphocytic leukemia
AML
AML affects all ages with peak incidence at age _____
67
2 types of treatment for AML
- aggressive chemo - induction therapy
- hematopoietic stem cell transplantation (HSCT)
3 stages of CML
- chronic phase
- transformation phase
- blast crisis
CML is Uncommon in people younger than _____ years, with increased incidence with age; mean age: _____ years
20
64
Manifestations for _____: initially may be asymptomatic, malaise, anorexia, weight loss, confusion or shortness of breath caused by leukostasis, enlarged tender spleen, or enlarged liver
CML
_____ is uncontrolled proliferation of immature cells from lymphoid stem cell
ALL
ALL is most common in _____ _____, _____ more often than girls, peak age _____ years old
young children
boys
4
ALL
Prognosis is good for children; _____% for 3-year event-free survival but drops with increased age
85%
<45%
3 major s/s related to leukemia
- anemia
- infection
- bleeding
2 main diagnostic tests for leukemia
- Bone marrow analysis
- peripheral blood smear
Chemotherapy:
- Single agent or combination chemotherapy -> eradicate leukemic cells, produce _____
- Combination therapy _____ cell growth at various stages of cell cycle
- Generally divided into ___ phases
- Postremission chemotherapy -> eradicate additional leukemic cells, prevent _____, prolong survival
- Single agent or combination chemotherapy -> eradicate leukemic cells, produce remission
- Combination therapy interrupts cell growth at various stages of cell cycle
- Generally divided into two phases
- Postremission chemotherapy -> eradicate additional leukemic cells, prevent relapse, prolong survival
Tw phases of chemo:
- _____ _____ -> high drug doses to eradicate leukemic cells
- Damage stem cells, production of _____ blood cells
- Colony stimulating factors (CSF)—hematopoietic growth factors—administered to rescue _____ _____ following induction chemotherapy
- Client may experience bone pain with _____
- _____ _____ -> eradicate additional leukemic cells, prevent relapse, prolong survival
- Induction phase -> high drug doses to eradicate leukemic cells
- Damage stem cells, production of normal blood cells
- Colony stimulating factors (CSF)—hematopoietic growth factors—administered to rescue bone marrow following induction chemotherapy
- Client may experience bone pain with CSFs
- Postremission chemotherapy -> eradicate additional leukemic cells, prevent relapse, prolong survival
_____ is treatment of choice for some types of leukemia
BMT (bone marrow transplant)
_____ _____ _____ _____: uses bone marrow cell from donor
allogenic bone marrow transplant
_____ _____ _____ _____: uses client’s own bone marrow to restore function after chemotherapy or radiation
autologous bone marrow transplant
2 types of BMT
- allogenic
- autologous
Graft-versus-host disease (GVHD):
- Allogenic BMT or SCT may precipitate GVHD -> _____% of clients
- Immune cells identify recipient’s body tissue as _____
- Acute -> within days
- Chronic -> _____ _____ days after transplant
60
foreign
> or = 100
What kind of therapy:
cytokines (interferons, interleukins) -> modify body’s response to cancer cells
Biological therapy
What kind of therapy:
- damages cellular DNS -> cell cannot divide and multiply
- rapidly dividing cells respons - bone marrow cells, cancer cells
radiation therapy
What?
- hyperuricemia, hyperphosphatemia, hyperkalemia, lactic acidosis, and hypocalcemia caused by the massive destruction of many neoplastic cells.
- Frequently, acute renal failure develops and, combined with electrolyte abnormalities, may rapidly become life- threatening.
Tumor Lysis Syndrome
Interventions:
- protect _____ _____ integrity
- promote health _____ _____
- easing _____ and _____
- decreasing _____ and _____ intolerance
- maintaining _____ and _____ balance
- _____ self-care, self-esteem, anxiety, etc.
- protect mucous membrane integrity
- promote healthy grief response
- easing pain and discomfort
- decreasing fatigue and activity intolerance
- maintaining fluid and electrolyte balance
- improve self-care, self-esteem, anxiety, etc.
