Unit 8 - Leukemia

Question 1

Definition:

Body produces large number of abnormal blood cells/usually white blood cells

Answer 1

Leukemia

Question 2

leukemia cells usually look _____ than normal blood cells and do not function properly
- often are _____ blasts that cannot grow into healthy blood cells

Answer 2

different

immature

Question 3

Malignant WBCs fill bone marrow, replacing _____ _____ that produce _____, other blood products -> _____ decrease amount of these products in circulation

Answer 3

stem cells
RBCs
decrease

Question 4

Leukemia diagnosed _____ times more often in adults than children

Answer 4

10

Question 5

_____ are affected more than _____ with leukemia

Answer 5

men are affected more than women

Question 6

Classified by acuity an predominant cell type involved:

• acute onset
• rapid disease progression
• immature, undifferentiated blast cells

Answer 6

acute leukemia

Question 7

Classified by acuity an predominant cell type involved:

• gradual onset
• prolonged course
• abnormal mature-appearing cells

Answer 7

chronic leukemias

Question 8

Classified by acuity an predominant cell type involved:

• involve immature lymphocytes and precursor cells in bone marrow
• infiltrate spleen, lymph nodes, CNS

Answer 8

lymphocytic leukemias

Question 9

Classified by acuity an predominant cell type involved:

• involve myeloid stem cells in bone marrow
• interfere with maturation of all types of cells

Answer 9

myeloid leukemias

Question 10

acute leukemia

• _____ onset
• _____ disease progression
• immature, undifferentiated _____ _____

Answer 10

• acute onset
• rapid disease progression
• immature, undifferentiated blast cells

Question 11

chronic leukemias

• _____ onset
• _____ course
• _____ mature-appearing cells

Answer 11

• gradual onset
• prolonged course
• abnormal mature-appearing cells

Question 12

lymphocytic leukemias

• involve immature _____ and _____ cells in bone marrow
• _____ spleen, lymph nodes, CNS

Answer 12

• involve immature lymphocytes and precursor cells in bone marrow
• infiltrate spleen, lymph nodes, CNS

Question 13

myeloid leukemias

• involve _____ _____ _____ in bone marrow
• interfere with _____ of all types of cells

Answer 13

• involve myeloid stem cells in bone marrow

- interfere with maturation of all types of cells

Question 14

Most common type of leukemia in children

Answer 14

acute lymphocytic leukemia

Question 15

Most common type of leukemia in adults

Answer 15

acute myeloid leukemia

Question 16

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 _____.

Answer 16

brain
leukemia
children
adolescents

Question 17

A defect in stem cell that differentiate into all myeloid cells: monocytes, granulocytes, erythrocytes, and platelets

Answer 17

AML

Question 18

Most common nonlymphocytic leukemia

Answer 18

AML

Question 19

AML affects all ages with peak incidence at age _____

Answer 19

67

Question 20

2 types of treatment for AML

Answer 20

• aggressive chemo - induction therapy

- hematopoietic stem cell transplantation (HSCT)

Question 21

3 stages of CML

Answer 21

• chronic phase
• transformation phase
• blast crisis

Question 22

CML is Uncommon in people younger than _____ years, with increased incidence with age; mean age: _____ years

Answer 22

20

64

Question 23

Manifestations for _____: initially may be asymptomatic, malaise, anorexia, weight loss, confusion or shortness of breath caused by leukostasis, enlarged tender spleen, or enlarged liver

Answer 23

CML

Question 24

_____ is uncontrolled proliferation of immature cells from lymphoid stem cell

Answer 24

ALL

Question 25

ALL is most common in _____ _____, _____ more often than girls, peak age _____ years old

Answer 25

young children boys 4

Question 26

ALL | Prognosis is good for children; _____% for 3-year event-free survival but drops with increased age

Answer 26

85% | <45%

Question 27

3 major s/s related to leukemia

Answer 27

- anemia - infection - bleeding

Question 28

2 main diagnostic tests for leukemia

Answer 28

- Bone marrow analysis | - peripheral blood smear

Question 29

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

Answer 29

- 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

Question 30

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

Answer 30

- 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

Question 31

_____ is treatment of choice for some types of leukemia

Answer 31

BMT (bone marrow transplant)

Question 32

_____ _____ _____ _____: uses bone marrow cell from donor

Answer 32

allogenic bone marrow transplant

Question 33

_____ _____ _____ _____: uses client's own bone marrow to restore function after chemotherapy or radiation

Answer 33

autologous bone marrow transplant

Question 34

2 types of BMT

Answer 34

- allogenic | - autologous

Question 35

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

Answer 35

60 foreign > or = 100

Question 36

What kind of therapy: | cytokines (interferons, interleukins) -> modify body's response to cancer cells

Answer 36

Biological therapy

Question 37

What kind of therapy: - damages cellular DNS -> cell cannot divide and multiply - rapidly dividing cells respons - bone marrow cells, cancer cells

Answer 37

radiation therapy

Question 38

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.

Answer 38

Tumor Lysis Syndrome

Question 39

Interventions: - protect _____ _____ integrity - promote health _____ _____ - easing _____ and _____ - decreasing _____ and _____ intolerance - maintaining _____ and _____ balance - _____ self-care, self-esteem, anxiety, etc.

Answer 39

- 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.