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What is leukemia A cancer that originates in the bone marrow from a single cell and multiples affecting healthy blood cells
How does acute and chronic differ? Acute are undifferentiated immature blast cells and have a short survival time and chronic mature nonfunctional cells with longer survival rate
What is the difference between myeloid and lymphoid cells? Myeliod turn into functional RBCs, PLTs, WBCs and lymphoids make t-cells or b-cells
What genetic factors are associated w leukemia? trisomy 21 (downs) and kliefelter's syndrome (XXY)
What other factors are associated w leukemia? virus (Epstein Bar, HIV), radiation, Drugs (chemo), chemicals (solvents, benzenes)
What labs are associated w leukemia? anemia (>4.5), neutropenia (>1,700), thromobocytopenia (>150,000), hyperuricemia (<6.8), increased LDH (<115)
How is a cytogenic analysis taken? through bone marrow
What are S/S of neutropenia? fever, abd pain, resp infection, perrectal abscess, mucositis, adenopathy
What are S/S of thrombocytopenia? petchiae, purpura, bleeding, gums, epitaxis, retinal hemorrhage, intracranial bleed
What are S/S of anemia? Pallor, dyspnea, fatigue, maliaise
What are S/S of leukemia infiltrates? HA, splenomeagaly, hepatomeagaly, pain and swelling in joints, lyphadenopathy
What are the primary goals of treatment? hematopoesis, eliminate residula dz, treat extramedullary sites, suppress resistant clones
What are the options for systemic treatment? chemo, target, and immunotherpay
How does acute treatment start and end? Starts with remission induction chemo and ends with post-remission consolidation
What leukemia uses CNS prophylaxis via intrathecal? ALL
Which leukemia uses stem cell transplant? AML, CLL
Which leukemmia does a watchful waiting? CLL
Which leukemia uses target therapy indefinitely? CML
Which leukemia has auer rods? AML
What factors make a PT more at risk for a poor prognosis? previous chemo or radiation, <70, WBC<100,000, previous blood disorder, infection, M5, or poor cytogenetics
What is the goal for AML? Bone marrow supression
When is a bone marrow aspiration done? day 14
What determines if "remission?" <5%
When is a bone marrow aspiration repeated? 3-4 weeks post induction
What is used during relapse of AML? Gemtuzumab ozogamicin (Mylotarg)
What is distinct of Leukemia M3? contains promyelocytes, 40% in DIC
What made Leukemia M3 have a much better prognosis? all-transretinoic acid (ATRA)
How many consolidation cycles does APL have to go through? 2
What are the three stages for CML? chronic, accelerated and blast crisis
What are the S/S of chronic phase? pallor, night sweats, fatigue, dyspnea, anemia, anorexia, wt loss, sternal tenderness, fullness, abd distension
What are the S/S of accelerated phase? chronic S/S + fever, hepatomeagaly, hypermetabolism, splenomegaly, lymphadenopathy
What is the survival rate expectancy of accelerated phase? one year
What are the nursing priorities for a neutropenic pt? watch for fever, ATB, ATF, cultures, CXR
what nincreases the risk of leukocytosis? WBCs <50,000
What are the consequences of hyperurecimia? gout like symptoms, renal obstruction, kidney failure
What are the treatments for hyperuricemia? allopurinol, hydration, and alkalization of urine
Where to most lymphomas arise from? b-cells
What type of cells do Hodgkins lymphoma have? Reed-sternberg cells
What grade is Burkitts? high grade, agressive
Which is more common? NHL or HL? NHL
What are the risk factors of HL? Epstein Bar, HIV, Mono, same sex siblings
What are the risk factors for NHL? hair dying, asbestos, rubber production, radiation, EBV, H.pylori
Where do lymphadenopathies occur in HL? cervical, subclavicular, and medistinal
Where to lymphadenopathies occur in NHL? Extranodule
Watchful waiting is associated with which, NHL? or HL? NHL
Created by: brebre273