Acute Lymphocytic Leukemia

Jonathan Bland

Pathophysiology BIO 1015

Professor Lori McGowan

W2A2

February 26, 2010

Acute Lymphocytic Leukemia

Given the information regarding the 6 year old boy my conclusion to his diagnosis would be
acute lymphocytic leukemia. Acute lymphocyte leukemia (ALL) is a type of cancer of the blood and
bone marrow the spongy tissue inside bones where blood cells are made. The "lymphocytic" in acute
lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute
lymphocytic leukemia is also known as acute lymphoblastic leukemia and acute childhood leukemia.
(Mayo Clinic, 2010) His signs and symptoms fall in to the category as being a close diagnosis. Other signs
and symptoms are bleeding from the gums, fever, frequent infections, frequent or severe nosebleeds,
pale skin, and shortness of breath (SOB), weakness, fatigue or a general decrease in energy, lumps
caused by swollen lymph nodes in and around the neck, underarm, stomach or groin.

My next investigation would be having the child under so more testing. Blood testing may reveal
too many white blood cells and not enough red blood cells. (Mayo Clinic, 2010)The blood test may also
reveal blast cells, which are immature cells found in the bone marrow that dont circulate in the blood.
The next test will be a bone marrow test. Where a needle is inserted into the hip bone and a small
portion of bone marrow is taken. This is a very painful test for the child to go through. With this they can
determine if the leukemia is B lymphocytes or T lymphocytes. Imaging tests such as computerized
tomography (CT) and chest X-rays may help determine where the cancer has spread throughout the
body. Spinal fluid tests such as a lumbar puncture to obtain spinal fluid. This test is used to determine if
the cancer has spread to the spinal fluid. The blood levels are T-cell leukemia: 106 g/L versus 76 g/L
(precursor B-cell acute lymphoblastic leukemia); within precursor B-cell ALL: TEL-AML1 positive: 68 g/L
versus 79 g/L; BCR-ABL positive: 93 g/L versus 76 g/L; each p<0.05). Furthermore, in contrast to the
entire study group, patients with T-cell leukemia, TEL-AML1+, and BCR-ABL+ precursor B-cell leukemia
had a more favorable prognosis if presenting with a higher hemoglobin level ( 80 g/L).

Acute Lymphocytic Leukemia

Pain varies with the degree of leukemia the child. He could have pain when the tests are done
especially when the child has the bone marrow tests. He could also have pain when he completes his
chemo therapy.

Treatment can include induction therapy which is the first phase of treatment designed to kill most
of the leukemia cells in the bone marrow. The next phase is consolidation therapy, which is postremission therapy. This phase of treatment is aimed at destroying the leukemia cells remaining in the
brain or spinal cord. The third phase is maintenance therapy prevents the leukemia cells from
regrowing. The last phase is Preventive treatment to the spinal cord. People with acute lymphocytic
leukemia may also receive treatment to kill leukemia cells located in the central nervous system during
each phase of therapy. In this type of treatment, chemotherapy drugs are injected directly into the fluid
that covers the spinal cord. This kills cancer cells that can't be reached by chemotherapy drugs given by
mouth or through an intravenous line. Depending on the situation, the phases of treatment for acute
lymphocytic leukemia can span 2 to 3 years. (Mayo Clinic, 2010) Treatment includes chemotherapy
which is designed to kill the cancer cells. This is used in the induction therapy for children and adults
with (ALL). They can be used in the consolidation and maintenance phase. Targeted drug therapy such
as Gleevac which is designed to attach specific types of cancer cells with an abnormality called the
Philadelphia chromosome. Radiation therapy uses X-rays to kill cancer cells. Stem cell transplant is used
in the consolidation therapy in people at high risk of relapse or for treating relapse when it occurs.
Another is clinical trials of new drugs that havent been fully approved by the FDA.

Acute Lymphocytic Leukemia

Works Cited
Mayo Clinic. (2010, Sept 4). Mayo Clinic. Retrieved Feb 26, 2011, from Acute lymphoblastic leukemia:
http://www.mayoclinic.com/health/acute-lymphocytic-leukemia/DS00558