WBC Disorders & Cancer Flashcards
what is the primary host defense against microbial infections?
WBCs
what is the #1 fighting cell?
neutrophils
neutrophils make up what percent of WBC volume?
5-60%
where does WBCs arise from?
bone marrow
types of WBCs
- lymphocytes
- monocytes
- eosinophils
- basophils
- neurophils
WBC cancers
- leukemia
- lymphoma
- multiple myeloma
leukemia
malignant proliferation of myeloid or lymphoid cells
acute leukemia
rapid accumulation of immature, non-fxnal WBCs in marrow
chronic leukemia
pts have more mature, fxnal WBCs because disease is slow to develop
chronic leukemia is common in adults of what age?
> 65 yo
med management of acute leukemia
- cure depends on tumor burden at diagnosis and the ability to rapidly eliminate the malignant WBCs
- chemotherapy
- bone marrow transplant if have a match
what are the 2 phases of chemotherapy for pts with acute leukemia
- induction and consolidation
2. maintenance
induction and consolidation phase of chemotherapy for pts with acute leukemia
hit hard, kill tumor cells
*goal is to get rid of as many tumor cells as possible
maintenance phase of chemotherapy for pts with acute leukemia
prevent expansion of remaining leukemic cells
at what phase in chemotherapy are pts in remission?
maintenance phase
can acute leukemia be cured?
yes!
do pts who are cured from acute leukemia easier to induce a relapse?
no, more difficult
is it possible for pts with chronic myelogenous secondary to chronic leukemia to obtain complete remission?
yes
is chronic lymphocytic secondary to chronic leukemia curable?
no, txtment has little effect on improving quality of life
lymphoma
cancer of lymphoid organs and tissues
which type of lymphomas are more aggressive?
higher grades
examples of lymphoma
- Hodgkin
- non-Hodgkin
med management of lymphoma
- induction chemo to shrink volume
- radiation to remaining mass
what is the cure rate of Hodgkins?
90%
what is the cure rate of non-Hodgkins?
60-70%
chemo and radiation can cause long-term complications in which organs?
- heart
- lungs
- thyroid
multiple myeloma
- lymphoproliferative disorder
- overproduction of malignant plasma cells
- multiple tumorous masses through the skeletal system
radiographic characteristic of multiple myeloma
punched out appearance of skull
overproduction of malignant plasma cells can cause what?
soft spots in bone so sets pts up for fracture
med management of multiple myeloma
- cancericidal chemotherapy
- palliative radiation
what is the survival rate of pts diagnosed with MM
5 yr survival rate (28-41%)
dental concerns of treating pts with WBC disorders
- infection
- delayed healing
- bleeding
dental care before cancer txtment
- consult with oncologist
- examination, radiographs as needed
- eliminate disease/infection before start of chemo/radiation
if did a full mouth ext on pt with WBC disorder, how long should pt wait before starting chemo?
at least 2 weeks
platelet count needs to be minimally at what number prior to surgery?
> 50,000 but if less then need replacement pre-op
WBC count prior to surgery?
> 2000 total count OR >500 neutrophils
if WBCs count is <2000 total count OR <500 neutrophils in pts prior to surgery, should you give them antibiotic prophylaxis?
yes
which antibiotic should be given to pts with low WBCs for antibiotic prophylaxis prior to surgery?
amoxicillin 2g 1 hour pre-op then 500mg 4x daily for 1 wk
guidelines for extraction pts
- be prepared to txt bleeding
- obtain primary closure if possible
- minimum 10-14 days between surgery and start of chemo/radiation
what types of dental care can be given to pts during cancer txtment?
- preventive care only (i.e. oral hygiene instruction, dental prophylaxis, caries control)
- NO ELECTIVE DENTAL CARE
what happens if a pt has a dental emergency during cancer txtment?
txt in coordination with oncologist
