Leukemia & Lymphoma Flashcards
(28 cards)
Leukemia
• A group of malignant disorders affecting the blood and blood‐forming tissues of: – Bone marrow – Lymph system – Spleen • Occurs in all age groups
Leukemia
• Results in an accumulation of dysfunctional cells because of a loss of regulation in cell division
• Fatal if untreated
– Progressive
Leukemia: Etiology and Pathophysiology
• No single causative agent
• Most from a combination of factors
– Genetic and environmental influences
Leukemia: Etiology and Pathophysiology
• Associated with the development of leukemia – Chemical agents – Chemotherapeutic agents – Viruses – Radiation – Immunological deficiencies
Leukemia: Classification; Acute vs. Chronic
• Acute versus chronic
– Cell maturity
• Acute: clonal proliferation of immature hematopoietic cells
• Chronic: mature forms of WBC; onset is more gradual
– Nature of disease onset
Leukemia: Classification; Type of WBC
• Type of white blood cell (WBC) – Acute lymphocytic leukemia (ALL) – Acute myelogenous leukemia (AML) • Also called acute non‐lymphoblastic leukemia (ANLL) – Chronic myelogenous leukemia (CML) – Chronic lymphocytic leukemia (CLL)
Acute Myelogenous Leukemia (AML)
• One quarter of all leukemias – 85% of the acute leukemias in adults • Abrupt, dramatic onset – Serious infections, abnormal bleeding • Uncontrolled proliferation of myeloblasts – Hyperplasia of bone marrow and spleen
Acute Lymphocytic Leukemia (ALL)
- Most common type of leukemia in children
- 15% of acute leukemia in adults
- Immature lymphocytes proliferate in the bone marrow
Acute Lymphotytic Leukemia (ALL): S&S
• Signs and symptoms may appear abruptly – Fever, bleeding • Insidious with progressive – Weakness, fatigue • Central nervous system manifestations
Chronic Myelogenous Leukemia (CML)
• Excessive development of mature neoplastic granulocytes in the bone marrow
– Move into the peripheral blood in massive numbers
– Ultimately infiltrate the liver and spleen
Chronic Myelogenous Leukemia
• Philadelphia chromosome
– Genetic marker
• Chronic, stable phase followed by acute, aggressive (blastic) phase
Chronic Lymphocytic Leukemia (CLL)
• Production and accumulation of functionally inactive but long‐lived, mature‐appearing lymphocytes
• B cell involvement
• Lymph node enlargement is noticeable throughout the body
– ↑ incidence of infecon
Chronic Lymphocytic Leukemia (CLL): Complications
• Complications from early‐stage CLL is rare
– May develop as the disease advances
– Pain, paralysis from enlarged lymph nodes causing pressure
Leukemia: Clinical Manifestations
• Relate to problems caused by
– Bone marrow failure
• Overcrowding by abnormal cells
• Inadequate production of normal marrow elements
• Anemia, thrombocytopenia, ↓ number and function of
WBCs
Leukemia: Clinical Manifestations
• Relate to problems caused by
– Leukemic cells infiltrate client’s organs
• Splenomegaly
• Hepatomegaly
• Lymphadenopathy
• Bone pain, meningeal irritation, oral lesions (chloromas)
Leukemia: Diagnostic Tests
• To diagnose and classify – Peripheral blood evaluation – Bone marrow evaluation • To identify cell subtype and stage – Morphological, histochemical, immunological, and cytogenic methods
Leukemia: Complications
- Opportunistic infections, including pneumonia
- Sepsis
- Congestiveheartfailure
- Hemorrhage
- Liverfailure
- Renalfailure
- CNS depression and coma
Lymphoma
- Malignant neoplasms originating in the bone marrow and lymphatic structures
- Result in the proliferation of lymphocytes
Lymphoma: Two major types
• Two major types of lymphomas
– Hodgkin’s disease
– Accounts for 15% of all lymphomas
– Non‐Hodgkin’s lymphoma (NHL)
Lymphoma: Risk Factors
- Auto immune disease (e.g.,rheumatoid arthritis)
- Exposure to pesticides, chemical solvents, dyes
- Exposure to some viral infections such as Epstein‐Barr virus
- Immunodeficiency states such as AIDS, congenital immunodeficiency, or chronic immunosuppression by medications
- Prior exposure to chemotherapy or radiation therapy
Hodgkin’s Disease
• Malignant condition • Characterized by – Proliferation of abnormal giant, multinucleated cells • Reed‐Sternberg cells – Located in the lymph nodes
Hodgkin’s Disease: Etiology and Pathophysiology
• Cause remains unknown • Several key factors play a role – Infection with Epstein‐Barr virus – Genetic disposition – Exposure to occupational toxins
Hodgkin’s Disease: Etiology and Pathophysiology
• Normal structure of lymph nodes is destroyed by hyperplasia of monocytes and macrophages
• Main diagnostic feature
– Presence of Reed‐Sternberg cells in lymph node biopsy specimens
Hodgkin’s Disease: Etiology and Pathophysiology
• Believed to arise in a single location – Spreads in adjacent lymphatics
– Eventually infiltrates other organs
• Lungs, spleen, liver
• Two‐thirds of clients are affected first in the cervical lymph nodes
