Leukemias In Infants
overproliferation of Granulocytes
LEUKEMIA - distorted and uncontrolled
proliferation of WBS.
•ACUTE LYMPHOCYTIC (lymphoblastic)
- involves lymphoblast (immature
lymphocytes)
-immature blast cell are abnormalities of
proliferating cells
Prognosis: WBC count higher than
50,000mm³ or more than 10% L2 cells
-Higher in boys, hispanic & white children.
2-6yrs of age
Factors: radiation, exposure to chemicals,
genetic factors (down syndrome)
ASSESS: anemia, pallor, lowgrade fever,
lethargy
-Low platelet leads to petechiae &
bleeding from oral nervouse membranes.
-swelling of Lymph nodes is revealed.
-Lumbar puncture as evidence of blast cell
in cerebrospinal fluid, bone marrow
aspiration (iliac crest) to identify WBC
involvement
MANAGE: Bone marrow transplantation ACUTE MYELOID LEUKEMIA–
Disease classification & prognosis – (Neutrophil, Basophil, Eosinophil)
B Lymphocyte cell & T Lymphocyte celle MANAGE: Diagnosis by bone marrow,
biopsy Chemo,
Goal: chemo, portactas inserted below
skin, drug remins of Vincristine,
Drug regimen: Cytarabine (Ara-c),
Prednisone or Dexametharon, L- Etoposide (Vepesid), daunorubicin
aspariginase & DoXorubicin in 4weeks. (daunoxome) 1-2months.
-To prevent kidney damage, Allopurinol to
reduce formation of uric acid.
- Intrathecal administration of
Methotrexate to eradicate source of
leukemia cells (BBB)
-In third phase (intensification phase) use
Vincristine, Prednisone, L-aspariginase,
doxorubicin, methotrexate, administer
Leucovorin after methotrexate to
neutralize normal cell.
Maintenance: Daily Mercaptopurine,
weekly Methotrexate, sporadic Vincristine
& Prednisone, Intrathecal methotrexate
and continued 2-3yrs
Complications: Blindness, kidney dmagae,
testicular invasion (local radiation for
effective treatment, sperm banking)