Acute Leukemia Research Paper
Leukemia: a type of cancer with uncontrolled production of immature WBC (usually blast cells) in the bone marrow. (MS, 880). Characterized by the replacement of bone marrow by malignant immature WBC(148, Pearson)
Acute Leukemia: sudden onset, rapid progression & immature or undifferentiated blast cells (148 P)
Chronic Leukemia: gradual onset, prolonged course and abnormal mature appearing cells. (148 P)
Lymphoblastic/lymphocytic : involve immature lymphocytes & their precursor cells in the bone marrow. Infiltrate spleen, lymph nodes, CNS & other tissue. (P148)
Myeloid : involve myeloid stem cells in the bone marrow interfering with the maturation of all types of blood cells including granulocytes, RBCs and thrombocytes. (P148) …show more content…
Most common in kids: acute lymphoblastic 148
Most common in adults: acute myeloid (AML) & chronic lymphocytic over 50 y/o (CLL) 148, 881
Associate with Philadelphia chromosome: chronic myeloid (CML) 149, 881
3 distinctive phases of drug therapy for acute leukemia: (884) Induction: intense & consists of combination of chemo started @ time of dx.
Purpose is to achieve rapid complete remission of all manifestations of the disease. Consolidation: often consists of another course of either the same drugs used for induction at a different dosage or a different combination of chemo drugs. Maintenance: may be prescribed for months to years after successful induction and consolidation therapies.
Treatments for CML: Gleevec first line oral drug well tolerated & effective @ inducing remission for early stages of CML (884)
Treatment for CLL: chemotherapy can cause remission but does not cure the disease. Decision to initiate therapy is based on the stage, symptoms, and disease activity. (884) often requires no treatment ; chemotherapy, bone marrow transplant (149)
Drug therapies for AML: antibiotic & antibacterial drugs for prevention or treatment of infection (aminoglycoside Abx, penicillin or 3rd gen cephalosporins) systemic antifungals when fungal infection diagnosed or neutropenic patient is febrile for 4-7 days after ABx therapy. Antivirals to prevent & treat viral infections. (acyclovir) 884 chemotherapy, stem cell transplant
(149)
Allogenic bone marrow transplant: uses bone marrow cells from a donor (often sibling w/ closely matched tissue antigens; closely matched donors can also be used). (155)
Hematopoietic stem cell transplantation HSCT: also called bone marrow transplant is standard treatment for the leukemia patient who has a closely matched donor & who is in temporary remission after induction therapy. 885
Autologous transplant: patient receive their own stem cells (collected before high dose therapy) 885
Syngeneic transplant: stem cells taken from the patients identical sibling (885)
Allogeneic transplants: closely matched sibling or an unrelated but matched donor provides the stem cells. (885)
5 phases of hematopoietic stem cell transplantation: stem cell obtainment, conditioning regemin, transplantation, engraftment, post-transplantation recovery (885)
The best results occur when the donor is an HLA identical sibling however transplant is also successful between those with closely matched HLA types. The chance of matching with any given sibling is 25% 885
Bone marrow harvesting occurs in OR through aspiration of iliac crest.886
3 possible complications of bone marrow testing: fluid loss, complications of anesthesia, & pain 886
Acute Leukemia: sudden onset, rapid progression & immature or undifferentiated blast cells (148 P)
Chronic Leukemia: gradual onset, prolonged course and abnormal mature appearing cells. (148 P)
Lymphoblastic/lymphocytic : involve immature lymphocytes & their precursor cells in the bone marrow. Infiltrate spleen, lymph nodes, CNS & other tissue. (P148)
Myeloid : involve myeloid stem cells in the bone marrow interfering with the maturation of all types of blood cells including granulocytes, RBCs and thrombocytes. (P148) …show more content…
Most common in kids: acute lymphoblastic 148
Most common in adults: acute myeloid (AML) & chronic lymphocytic over 50 y/o (CLL) 148, 881
Associate with Philadelphia chromosome: chronic myeloid (CML) 149, 881
3 distinctive phases of drug therapy for acute leukemia: (884) Induction: intense & consists of combination of chemo started @ time of dx.
Purpose is to achieve rapid complete remission of all manifestations of the disease. Consolidation: often consists of another course of either the same drugs used for induction at a different dosage or a different combination of chemo drugs. Maintenance: may be prescribed for months to years after successful induction and consolidation therapies.
Treatments for CML: Gleevec first line oral drug well tolerated & effective @ inducing remission for early stages of CML (884)
Treatment for CLL: chemotherapy can cause remission but does not cure the disease. Decision to initiate therapy is based on the stage, symptoms, and disease activity. (884) often requires no treatment ; chemotherapy, bone marrow transplant (149)
Drug therapies for AML: antibiotic & antibacterial drugs for prevention or treatment of infection (aminoglycoside Abx, penicillin or 3rd gen cephalosporins) systemic antifungals when fungal infection diagnosed or neutropenic patient is febrile for 4-7 days after ABx therapy. Antivirals to prevent & treat viral infections. (acyclovir) 884 chemotherapy, stem cell transplant
(149)
Allogenic bone marrow transplant: uses bone marrow cells from a donor (often sibling w/ closely matched tissue antigens; closely matched donors can also be used). (155)
Hematopoietic stem cell transplantation HSCT: also called bone marrow transplant is standard treatment for the leukemia patient who has a closely matched donor & who is in temporary remission after induction therapy. 885
Autologous transplant: patient receive their own stem cells (collected before high dose therapy) 885
Syngeneic transplant: stem cells taken from the patients identical sibling (885)
Allogeneic transplants: closely matched sibling or an unrelated but matched donor provides the stem cells. (885)
5 phases of hematopoietic stem cell transplantation: stem cell obtainment, conditioning regemin, transplantation, engraftment, post-transplantation recovery (885)
The best results occur when the donor is an HLA identical sibling however transplant is also successful between those with closely matched HLA types. The chance of matching with any given sibling is 25% 885
Bone marrow harvesting occurs in OR through aspiration of iliac crest.886
3 possible complications of bone marrow testing: fluid loss, complications of anesthesia, & pain 886