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  • Acut Lymphoblastic Leukemia

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    Ahyar Nur
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    The document discusses acute lymphoblastic leukemia (ALL) in children. It provides background on ALL, noting that it is a malignant disease caused by the infiltration of immature lymphoblasts in bone marrow and lymphatic organs. It then discusses the epidemiology, incidence, clinical signs and symptoms, diagnostic testing, classification, prognostic factors, and management of ALL. The management involves induction of remission through chemotherapy with drugs like vincristine and dexamethasone, intensification/consolidation therapy, central nervous system treatment, and continuation therapy, all with the goal of eradicating leukemic cells. It concludes by noting challenges in diagnosis, cost, and treatment complications for ALL patients.

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    ALL

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    The document discusses acute lymphoblastic leukemia (ALL) in children. It provides background on ALL, noting that it is a malignant disease caused by the infiltration of immature lymphoblasts in bone marrow and lymphatic organs. It then discusses the epidemiology, incidence, clinical signs and symptoms, diagnostic testing, classification, prognostic factors, and management of ALL. The management involves induction of remission through chemotherapy with drugs like vincristine and dexamethasone, intensification/consolidation therapy, central nervous system treatment, and continuation therapy, all with the goal of eradicating leukemic cells. It concludes by noting challenges in diagnosis, cost, and treatment complications for ALL patients.

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    © All Rights Reserved
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    11 views15 pages

    Acut Lymphoblastic Leukemia

    Uploaded by

    Ahyar Nur
    The document discusses acute lymphoblastic leukemia (ALL) in children. It provides background on ALL, noting that it is a malignant disease caused by the infiltration of immature lymphoblasts in bone marrow and lymphatic organs. It then discusses the epidemiology, incidence, clinical signs and symptoms, diagnostic testing, classification, prognostic factors, and management of ALL. The management involves induction of remission through chemotherapy with drugs like vincristine and dexamethasone, intensification/consolidation therapy, central nervous system treatment, and continuation therapy, all with the goal of eradicating leukemic cells. It concludes by noting challenges in diagnosis, cost, and treatment complications for ALL patients.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 15

    Doc. Arifin Dwi Atmaja, S. Kep.

    Asuhan Keperawatan Pasien


    Anak dengan Acut
    Lymphoblastic Leukemia


    Arifin Dwi Atmaja, S. Kep.
    Doc. Arifin Dwi Atmaja, S. Kep.
    Introduction
    Leukemia: 25-35% Childhood Cancer
    ALL:
    Malignant Disease
    Progressive Infiltration of Bone Marrow and
    Lymphatic Organs by immature lymphoid
    cell lymphoblasts


    Doc. Arifin Dwi Atmaja, S. Kep.
    Etiology and Epidemiology
    Radiation
    Chemicals
    Drugs
    Viruses
    Genetic Abnormalities
    Doc. Arifin Dwi Atmaja, S. Kep.
    Incidence
    3 per 100.000 children
    Peak: 2-6 years
    Sardjito (1992-1998) Leukemia= 48%
    Indonesia problems:
    Registration, Protocol, Specific diagnosis,
    Cost (drugs and suportive)
    Doc. Arifin Dwi Atmaja, S. Kep.
    Prognosis
    Poorer Countries: prognosis poor
    Many patients without any treatment

    Doc. Arifin Dwi Atmaja, S. Kep.
    Clinical Signs
    Symptoms:
    Malaise, Fatigue
    Bleeding, bruising
    Fever
    Bone pain
    Lymphadenophaty (80%
    Splenomegali and hepatomegali (70-75%)
    Enlargement of the testes
    CNS: Intracranial pressure > and cranial nerve
    palsies)
    Doc. Arifin Dwi Atmaja, S. Kep.
    Laboratory and Radiology
    Peripheral blood: anemia,
    trombocytopenia, Neutropenia
    Bone marrow Aspirate: >25% leukemia
    lymphoblasts
    Radiographic: Mediastinal mass (5-10%)
    Doc. Arifin Dwi Atmaja, S. Kep.
    FAB Classification
    Morphological classification:
    French-American-British (FAB):
    L1: 80%, L3:< 2%, L2: the Remainder

    L1: Higher remission
    Prolonged survival than L2 and L3
    L3: The worst prognosis

    Doc. Arifin Dwi Atmaja, S. Kep.
    Prognostic Factors
    WBC, Hb, Trombosit
    Age
    Cytogenetic
    Age
    Organomegaly
    FAB Morphology
    Immunophenotype
    Mediastinum mass, Sex, CNS disease
    Doc. Arifin Dwi Atmaja, S. Kep.
    ALL Management in childhood
    Four components
    Remission induction
    Intensification
    CNS treatment
    Continuation
    The purpose: eradicate leukemic cells
    Doc. Arifin Dwi Atmaja, S. Kep.
    Remission induction
    Regimen:
    Vincrisrine (VCR)
    Dexzamethasone
    Methotrexate (MTX) intratekal
    Daunorobicin (Dauno) hanya untuk resti
    L-asparaginase
    Doc. Arifin Dwi Atmaja, S. Kep.
    Problems:
    Difficult diagnosis
    Education/ information
    No cost, no delay
    Complications/ failure
    Doc. Arifin Dwi Atmaja, S. Kep.
    Intensification/ consolidation
    Combination:
    MTx iv, 6- MP and L-asp
    Problems: cost, complications, isolation
    room
    Doc. Arifin Dwi Atmaja, S. Kep.
    Supportive care
    Hemorrhage
    Infection
    Leukemia patients association
    Doc. Arifin Dwi Atmaja, S. Kep.
    Terima kasih

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