PREDISPOSING FACTOR

– Genetic
○ damage to genes controlling cell growth, and changes cells from a normal to a malignant (cancer)
○ abnormal chromosomes about 50%

– Chemicals and Drugs

○ Because of ability to damage the DNA
– bone marrow hypoplasia (reduced production of blood cells)
– immunologic factors
○ Immunologic factors, especially immune deficiencies, may promote the development
of leukemia.
– environmental factors
○ ionizing radiation exposures such as radiation therapy for cancer treatmen
 SIGNS AND SYMPTOMS
Integumantary Manifestations:
 Ecchymoses Respiratory Manifestations:
 Petechiae  Dyspnea on exertion.

 Open infected lesions Neurologic Manifestations:

 Pallor of the conjunctiva, nail  Fatigue
beds, palmar creases, and  Headache
around the mouth.  Fever
 Musculoskeletal Manifestations:
Gastrointestinal Manifestations:  Bone pain
 Bleeding gums  Joint swelling and pain.
 Anorexia

 Weight loss
 Enlarged liver and spleen
Renal Manifestations:
 Hematuria
Cardiovascular Manifestations:
 Tachycardia

 Palpitations
POSSIBLE COMPLICATIONS
Tumor lysis syndrome: rapid destruction of large numbers of
malignant cells leads to alteration in electrolytes

1. May lead to renal failure and other complications.

2. Infection, bleeding, and organ damage.

 ETIOLOGY
CAUSATIVE AGENT – ALL BEGINS WITH A SINGLE
MUTATION CELL IN THE BONE
MARROW
– ERRORS CAN OCCUR
– CERTAIN CHROMOSOMAL
WHEN CELLS COPY THEIR
MUTATIONS CAN ALTER
DNA (CROSSING OVER)
DNA MAKING NORMAL
THAT ALTER THE GENES
BONE MARROW CELLS
WITHIN THE DNA
BECOME LEUKEMIA CELLS
INSTEAD
 RECIPROCAL – CAUSES CHROMOSOME 22
TRANSLOCATION TO BE ABNORMALLY
– WHEN A SEGMENT OF DNA SHORT
FROM ONE CHROMOSOME – THROUGH DNA
BREAKS OFF AND REPLICATION MANY
ATTACHES TO ANOTHER, MUTANT CELLS ARE
NON HOMOLOGOUS ONE PRODUCE GIVING RICE TO
– THE MOST COMMON TYPE LEUKEMIA
OF CHROMOSOMAL DELETION
ABNORMALITY THAT CAN – REMOVAL AND LOSS OF A
LEAD TO LEUKEMIA SEGMENT OF DNA FROM A
EG. PHILADELPHIA CHROMOSOME
CHROMOSOME INVERSIONS
– SWAPPING OF DNA – THE REVERSAL OR
SEGMENTS BETWEEN REARRANGMENT OF A
CHROMOSOME 22 AND 9 SEGMENT OF DNA WITHIN
A CHROMOSOME
 RISK FACTORS
RADIATION EXPOSURE FACTORS ASSOCIATED
CHEMICAL EXPOSURE WITH ALL
-ONE OF THE MOST - VIRAL INFECTION
COMMON NOTICED RISK
 INFECTION WITH THE
HUMAN T CELL LYMPHOMA
- INHERITED SYNDROMES
EG. DOWN SYNDROME
– ETHNICITY
ALL NOTABLY MORE
PREVALENT IN WHITES
THAN IN BLACKS
– GENDER

ALL IS SLIGHTLY MORE

COMMON IN MALES THAN
FEMALES

DISEASE PROCESS
 ALL BEGINS WITH A CHROMOSOMAL MUTATION THAT
ALTERS THE DNA OF A WBC IN THE BONE MARROW
-WBC –LYMPHOBLAST PLAYS A MAJOR ROLE IN IMMUNE
SYSTEM
-MUTATION TURNS NORMAL BONE MARROWN WBC INTO
LEUKEMIA CELL
2.THE LEUKEMIA CELL THEN CONTINUES TO MULTIPLY AND
OVERPRODUCE IN THE BONE MARROW (RBC ,WBC,
PLATELETS)
3.LEUKEMIA INVADES THE BLOOD FAIRLY QUICKLY
- THE ACUTE IN ALL MEANS THE LEUKEMIA PROGRESSES VERY
RAPIDLY
4. IN ALL BONE MARROW CELLS CANNOT MATURE PROPERY
THIS ALLOWS IMMATURE LEUKEMIA CELLS TO REPRODUCE AND
BUILD UP
5. IF LEFT UNTREATED IT WOULD BE FATAL FOR A FEW MONTHS
 MANAGEMENT
MEDICAL HISTORY,PE CBC
LAB TEST XRAYS
MD USES TEST RESULTS TO DETERMINE
DRUG THERAPY DURATION OF TREATMENT
MAIN – CHEMOTHERAPHY-KILL CANCER CELLS
4 PHASES OF TREATMENT
RADIATION THERAPHY
STEM CELL TRANSPLANT
 PROGNOSIS
OVERALL SURVIVAL RATE FOR ALL IS
APPROXIMATELY 80 PERCENT.
WITH SERIES OF CHEMOTHERAPHY AND BT
PATIENT WAS IMPROVED AND LOST SOME OF THE
MANIFESTATIONS OF THE DISEASE
PATHOPHYSIOLOGY
RISK FACTOR