Pathophysiology

Predisposing Factors: Age Gender Race Family HIstory Precipitating Factors: having a
sibling withexposure to radiation and certain chemicals chromosomal genetic
abnormalities  HTLV-1 virus leukemia translocations

ETIOLOGY: Unknown

Somatic mutations in the DNA

Activate oncogene/ deactivate tumorsupppresor gene

Malignant transformation of lymphoid stem cells s/sx: bone pain joint pain

Uncontrolled proliferation of lymphoblast in the bone marrow Diagnostic Test: BM

aspiration BM biopsy

Treatment: Analgesic

Lymphoblast replace the normal marrow elements

Treatment: BM Consolidation and Maintenance Therapy Remission Induction

Therapy Transplantation

Diagnostic Test: CBC

Leukopenia (↓4.36 x 10 /L)

9

Decreased production of normal blood cells Decreased production of normal blood cells
Spillage of lymphoblast into the bloodstream

s/sx: fever, chills seizure

Infection

s/sx: bruise presence of petechiae  &  fatigue  anemia bleed easily dyspnea
palpitations dizziness

BloodTreatment: Epoetin and hemapoetic stimulantstransfusion

Organ infiltration If treated: Antibiotic Ig Leukapheresis If not treated

Septicemia
Prevention of complications

Death

Kidneys


Renal     failure

s/sx: Little/ no UO ↑RR Flank pain Restless n/v legs and feet swelling

Diagnostic Test: MRI Treatment: Intrathecal chemotherapy

CNS s/sx: h/a, weakness, blurred vision, balance difficulty, vomiting, lethargy Liver /
Spleen Diagnostic Test: Ultrasonography

leukocyte cells impairs the circulation of CSF

s/sx: ↑ CSF leukocytes s/sx: cranial nerve palsies confusional states optic neuropathy
cerebellar dysfunction papilledema

Extra cells cause the liver/spleen to rupture

Diagnostic Test: Spinal Tap

leukocyte cells compresses spinal/ cranial nerves

bleeding Hypovolemic shock

s/sx: hepatomegal y splenomegaly elevated ALT (81 u/L) s/sx: hypotension

tachypnea tachychardia

Progress to coma

Overgrown thymus

Compress the Superior Vena Cava

s/sx: shortness of breath cough suffocation

Physical Exam Diagnostic test: Lymph node biopsy

Lymph nodes

Mediastinal lymphadenopathy
s/sx: lymphadenopathy SVC syndrome s/sx:  obstruction of blood flow Treatment:
swelling of head, neck and arms Bronchodilator s s/sx: cough, wheezes,
respiratoryO2 administration tract obstruction

Bronchial/tracheal obstruction Esophageal compression

s/sx: dysphagia

Erosion of node into a bronchus/ trachea

s/sx: hemoptysis

Severe hypoxia

DEATH