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What are the 4 major types of leukemia?
- Acute Lymphocytic Leukemia (ALL)
- Chronic Lymphocytic Leukemia (CLL)
- Acute Myeloid Leukemia (AML)
- Chronic Myeloid Leukemia (CML)
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Risk factors for leukemia are?
- •Men are affected more than women
- •People with genetic disorders (ex Down syndrome) have a higher incidence of leukemia
- •environmental risk factors cigarette smoke Nd chemicals)
- •patients who have underwent treatment for cancer
- •the human T-Cell leukemia/lymphoma virus 1 a retrovirus us known to cause certain leukemia
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Classification of Leukemia Acute/Chronic
They are classified by their acuity and by the predominant cell type.
The Acute leukemia's are characterized by their sudden onset, rapid cell progression, and immature/undifferentiated blast cells
The Chronic leukemia's are characterized by their gradual onset, prolonged course, and abnormal mature-appearing cells
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Classification of Leukemia's by Lymphocytic/Myeloid
- Lymphocytic leukemia's involve immature lymphocytes and their precursor cells in the bone marrow.
- Lymphocytic leukemia's infiltrate the SPLEEN, LYMPHNODES, CNS and other tissues
Myeloid leukemia's involve the myeloid stem cells in the bone marrow, interfering with the maturation of ALL types of blood cells including Granulocytes, RBC's, and Thrombocytes
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Acute Lymphoblastic Leukemia
- •Primarily affects children and young adults
- •Most common type of leukemia in children especially age 10 and ⬇
- •Leukemic cells may infiltrate the CNS
- •Malignant transformation of B cells
- •involves bone marrow, nodes, spleen and blood
- •Onset is rapid
- •WBC differential test will show ⬆ lymphocytes, ⬇ platelet, and ⬇ RBC's
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A.L.L s/s
- •Bleeding
- •Anemia
- •Bone pain
- •Lymphadenopathy
- •Hepatomegaly
- •Infections/Fever
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A.L.L treatment
- Induction Chemotherapy and Consolidation Chemotherapy
- **Can go on for 1-3 years**
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Chronic Lymphocytic Leukemia
- •Is the LEAST common type of leukemia
- •Occurs more commonly in adults (more men than women between 60-70y/o)
- •Proliferation/accumulation of small, abnormal, mature B Lymphocytes in the bone marrow, peripheral blood, and body tissues
- •Can be diagnosed from a blood test
- •Can be in a mild form that they don't treat it they just watch it (years can lapse before treatment is necessary)
- •Slow onset
- •Related to NON-HODGKINS
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C.L.L s/s
- Weakness
- Anemia
- INFECTION
- ENLARGED LYMPHNODES
- Splenomegaly
- Hepatomegaly
- Bone marrow hyperplasia is present
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C.L.L treatment
- Chemotherapy
- bone marrow transplant
- biologic therapies;interferons, interleukins
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Acute Myeloblastic Leukemia
Uncontrolled proliferation of myeloblasts and hyperplasia of bone marrow and spleen
Common in oldest adults
May affect children and hound adults
Strongly associated with toxins, genetic disorders, and treatment from other cancers
Death results from infections/hemorrhage
acute onset and progresses rapidly
80% of acute leukemia's in adults are AML
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AML s/s
- Bleeding
- Anemia
- Bone pain
- Lymphadenopathy
- Hepatomegaly
- spleenomegaly
- recurrent infections
- weakness
- fever
- ANEMIA (usually late sign not good prognosis)
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AML treatment
- Chemotherapy
- Stem Cell Transplant
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Chronic Myelogenous Leukemia
- •Associated with the Philadelphia Chromosome
- •Primarily affects adults
- •Early course slow and stable
- •Progressing to aggressive phase in 3-4 years
- •Can be picked up at a check up (routine blood test)
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CML s/s
Similar to AML
- Early signs: weakness, fatigue, dyspnea on exertion, poss splenomegaly, ⬇ appetite
- Later signs: fever, weight loss, night sweats
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CML treatment
- TKI (tyrosine kinase inhibitor) this has improved prognosis, more than 90% get remission.
- Stem Cell Transplant
- Chemotheraphy
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what has best prognosis, hodgkins or non-hodgkins
Hodgkins
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which hodgkins has Reed Steinberg cells
hodgkins
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what differentiates hodgkins and non hodgkins
reed sternberg cells
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what luekemia is marked by epstein barr virus (mono)
hodgkins
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what cells are affected in lymphomas
B-cells and T cells
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what leukemia lays dormant and has 7 year life expectancy
Chronic lymphocyte leukemia (CLL)
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age range for C.L.L.
60-70 mostly men
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what can help pts with Chronic myeloid leukemia go into remission
TKI's (tyrosine kinase inhibitors)
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what is the most common cancer in children
acute lymphocytic leukemia
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what cancers are usually dx with routine CBC
chronic leukemias (CML and CLL)
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what is hyperplasia
rapid production of cells (neoplastic cells)
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what chemical makes ppl more suspectible to leukemias especially AML
Benzyne
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neutropenia is catagorized by what
low neutrophil count <1500
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what CA is marked by uncontrolled rapid proliferation of myeloblast and hyperplasia of bone marrow and spleen
AML
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which two leukemias have worse prognosis
AML and CML
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difference between CML and AML (as far as cells are concerned)
CML involves white and red cells as well as platelets. AML involves white cells only
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which CA is marked by philidelphia chromosome
CML
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which CA is marked by malignant transformation of B cells
A.L.L
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which CA has no identified risk factors
A.L.L.
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which CA causes the enlarged spleen
CML and AML
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difference in symptoms between AML and CML
CML has increased plateles at the beginning then platelets decrease
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difference between CML and CLL is
- CML has Philadelphia chromosome
- CLL can lay dormant and doesnt always req treatment, best leukemia to have
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What system do they use for hodgkins and non-hodgkins and lymphoma staging
Ann arbor staging system
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