Leukemia

Research and Reported by:
JBI Anne B. Ibarra
BN41

Leukemia
Definition
It is a group of malignant disorder, affecting the
blood and blood –forming tissue of the bone
marrow lymph system and spleen.
Etiology
 Combination of predisposing factors including
genetic and environmental influences.
 Chronic exposure to chemical such as
benzene
 Radiation exposure.
 Cytotoxic therapy of breast, lung and testicular

.Classification of leukaemia 1. with impaired maturation and accumulation of the malignant cells in the bone marrow. older adult Pathophysiology It arise from a single lymphoid stem cell. 1. Acute lymphatic leukaemia (ALL) Usually occurs before 14 years of age peak incidence is between 2-9 years of age.

Acute lymphatic leukaemia Cont. Signs and symptoms Anaemia. infection Clinical manifestation Clinical manifestation Fever Pallor Bleeding Anorexia Fatigue Weakness Bone. bleeding. joint and abdominal pain Increase intracranial press. Generalized lymphadenopathy Infection of respiratory tract Anaemia and bleeding of mucus membrane Ecchymoses Weight loss Hepatomegaly Mouth sore . lymphadenopathy.

Acute lymphatic leukaemia Cont. Consolidation: Using modified course of intensive therapy to eradicate any remaining. 3. Hct. Maintenance . 2.  Blood smear show immature lymph blasts. low platelet count . Treatment Chemotherapeutic agent. Management Diagnosis  Low RBCs count. Induction: Using vincristine and prednisone. low normal or high WBC count. it involve three phases 1. Hb.

. fibres and fluids. intrathecal administration and /or craniospinal radiation with eradicate leukemic cells. Treatment Cont.  Prophylactic treatment of the CNS .  Eat diet that contains high in protein.Acute lymphatic leukaemia Cont.

smoking and spicy and hot foods. .  Maintain oral hygiene.  Avoid infection (hand washing. avoid crowds). Treatment Cont.Acute lymphatic leukaemia Cont.injury  Take measure to decrease nausea and to promote appetite.

low to high WBC count with myeloblasts. . Clinical manifestation Similar to ALL plus sternal tenderness. Hct. low platelet count. Management Diagnosis Low RBC.Acute Myelogenous Leukaemia (AML) It occurs at any age but occurs most often at adolescence and after age of 55 Pathophysiology Characterized by the development of immature myeloblasts in the bone marrow. Hb.

 The same care of client as All. effects.)  Instruct client about medication.Acute Myelogenous Leukaemia (AML) Cont. Treatment Use of cytarabine. plus give adequate amounts of fluids(2000 to 3000 ml per day. side effects and nursing measures  .

Pathophysiology  It is characterized by proliferation of small.It is common in men.  The number of mature lymphocytes in peripheral blood smear and bone marrow are greatly increased . often leading to decreased synthesis of immunoglobulin and depressed antibody response. abnormal . mature B lymphocytes.Chronic lymphocytic Leukaemia (CLL) The incidence of CLl increases with age and is rare under the age of 35.

 Anaemia  Thrombocytopenia.000. Chronic fatigue .000 to 100. . hepatomegaly.Chronic lymphocytic Leukaemia (CLL) Cont Clinical Manifestation Usually there is no symptoms. weakness . lymphadenopathy. splenomegaly .  The WBC count is elevated to a level between 20. anorexia. Signs and Symptoms  Pruritic vesicular skin lesions .

I.Chronic lymphocytic Leukaemia (CLL) Cont Management I. particular anaemia . I. thrombocytopenia . Client and family education is that describe for AML. . Persons are treated only when symptoms. enlarged lymph nodes and spleen appear. Chemotherapy agents such as chlorambucil . and the glucocorticoids.

weakness. fever. Clinical Manifestation There is no symptoms in disease.  . sternal tenderness. include:  Fatigue. Peak 45 year It is caused by benzene exposure and high doses of radiation. The classic symptoms of chronic types of leukaemia.Chronic Myelogenous Leukaemia(CML) Occurs between 25-60 years of age.

Chronic Myelogenous Leukaemia(CML) Cont.  There is a corresponding anaemia and thrombocytopenia.  Massive splenomegaly and increase in sweating. . Clinical Manifestation Cont.  The accelerated phase of disease(blostic phase) is characterized by increasing number of granulocytes in the peripheral blood.

Hct. lower count later. Normal number of lymphocytes and normal or low number of monocytes in WBC differential. Treatment The commonly drugs are hydroxyurea and busulfan (monitor of WBC count needed with therapy).Chronic Myelogenous Leukaemia(CML) Cont. . high platelet count early. Hb. Management Diagnosis Lower RBC count.

Promoting safety. Preventing fatigue. Treatment Cont. Providing oral hygiene. Nursing Intervention Taking measures to prevent infection.Chronic Myelogenous Leukaemia(CML) Cont. The only potential curative therapy of CML is the bone marrow transplant. . Client and family education. Promoting effective coping.

Detection of Leukemia      Blood test Bone Marrow Test Spinal Tap Immunophenotyping Cytogenetic and Chromosome Analysis .

Detection: Imaging Techniques      Chest X-Ray Ultrasound Bone or Gallium Scan CT Scan MRI .

1 in every 4 cases of AML is linked to smoking. Exposure to Benzene Previous chemotherapy or radiation treatment .Prevention of Leukemia    Cigarette smoking.

targeted therapy. .Management of Leukemia  Leukemia treatment options include chemotherapy. radiation therapy. stem cell transplantation or bone marrow transplants. biological therapy. and surgery (for a splenectomy).

or to kill the leukemia cells. This type of treatment can be administered as a single drug or in combination with other drugs. Chemotherapy is a systemic treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the leukemia cells.Chemotherapy  Most of the patients that suffer from leukemia receive chemotherapy and targeted therapy. .

Radiation Therapy or Radiotherapy:  Radiation therapy is a cancer treatment which uses high-energy rays or particles to destroy cancerous cells (leukemia cells). .

Nursing Care in Radiotherapy      Assessing contributing factors. and encouraging patient to rest and limit daily activities. Gently brush and comb. infrequently shampoo Avoid the use of hair coloring and chemical Give psychological support for change of body image Give advice for using wig if necessary .

. the patient receives healthy bone marrow cells from a donor. During this procedure.Stem Cell Transplantation or Bone Marrow Transplant:  This is a treatment option for some leukemia patients. either yourself as a donor or someone else.

an alternative used when the spleen has colleted a high amount of leukemia cells. .Surgery:  The only type of surgery used as a treatment option for leukemia is splendectomy (the surgical removal or the spleen). and its swelling causes an increased level of discomfort for the patient.

Rehabilitation Therapies for Leukemia      The following are some of the oncology rehabilitation therapies you may incorporate into your leukemia treatment: Physical Therapy Occupational Therapy: ReBuilder: Massage Therapy: .

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