LEUKEMIA
Malignant Disorders:
affecting blood and blood forming tissues of bone marrow, lymph, and spleen
Etiology: Genetic and envirnomental
Patho:
1. Immauture haematopoietic cells
2. Normal blood cells lose mitotic activity as they mature
3. Leukemic cells infiltrate organs including CNS
4. Bone marrow is crowded with leukemic cells
Classification: Acute and Chronic
1. ACUTE LYMPHOCYTIC LEUKEMIA (ALL)
- childreN
- Patho: proliferation immature lymphocytes
- Prognisis: 90% survival kids; 50% adults
- S&S: fever, weakness, fatigue, bleeding, CNS
- DX: Bone Marrow aspiration and biopsy; blasts, increased
WBCs, decreased RBCs and platelets
2. ACUTE MYELOGENOUS LEUKEMIA (AML)
- adults: accounts for 85% acute leukemias
- is a proliferation of myeloblasts & hyperplasia of bone
marrow and spleen
- S&S: blood cells in marrow replaced by leukemic cells --->
anemia, low platelets; WBCsL either low or high (immature),
fatigue, weakness, HA, fever, chills, bleeding, infection, sores
3. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)
- most common leukemia in adults
- patho: disorder B lymphocytes; therefore normal antibody
response is decreased, increased infection problems, mature
appearing, but functionally inactive
-S&S: fatigue, anorexia, thrombocytopenia --- poor prognosis
4. CHRONIC MYELOGENOUS LEUKEMIA (CML)
- increased development neoplastic granulocytes which move
into peripheral blood
- immature and mature cells in bone marrow & peripheral blood
- survival poor: can usually be controlled with treatment BUT:
the only cure is a bone marrow transplant!
TREATMENT OF LEUKEMIA
Chemotherapy and radiation:
GOAL: Induce Remission
Step1: Induction therapy
Goal: Induce remission
Patient very ill d/t aggressive RX
Meds to reduce nausea; cold packs to prevent hair loss
Step 2: Intensification therapy
Immediately after induction
Step 3: Consolidation therapy
After remission achieved
Step 4: Maintenance therapy
Other RX:
Radiation
Bone Marrow Transplant