Leukemia Medical Presentation

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Published on : Apr 07, 2019 | Views : 3225 | Downloads : 20

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leukemia
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List of contents. Introduction. Etiology. Brief anatomy. Diagnosis. Staging and spread. Treatment. Radiation therapy. Reference .
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A. Introduction We all know that leukemia is type of cancer but what is the cancer ?
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A. Introduction Cancer definition: is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body Leukemia definition: -is a cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. -is a group of cancers in the bone marrow and result in high numbers of abnormal white blood cells.
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B. Etiology. Leukemia happens when the DNA of immature blood cells, mainly white cells, becomes damaged in some way healthy blood cells die after a while and are replaced by new cells, which are produced in the bone marrow, The abnormal blood cells do not die when they should
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B. Etiology. factors increase the risk of developing leukemia: ionizing radiation. viruses, such as the human T-lymph tropic virus and HIV. benzene and some petrochemicals. alkylating chemotherapy agents used in previous cancers. hair dyes. Smoking.
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C. Brief anatomy. Blood is made up of liquid called plasma and solid cells, Blood cells are made in the bone marrow, Bone marrow is the soft spongy substance in the center of bones. Leukemia can be divided into four main groups. These groups distinguish Acute. chronic. lymphocytic. myelogenous leukemia.
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C. Brief anatomy. It is most likely to affect people over 55 years but it also is the most common cancer in those aged under 15 years.
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C. Brief anatomy. Fast facts on leukemia, Here are some key points about leukemia: 1-About 62,130 new cases of leukemia are expected to be diagnosed in the United States in 2017. 2-Leukemia is one of the most common childhood cancers, but it most often occurs in older adults. 3-Leukemia can be fatal, but there are ways of treating and controlling the disease and its symptoms.
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D. Diagnosis A doctor will carry out a physical examination and ask about personal and family medical history. They will check for signs of anemia and feel for an enlarged liver or spleen, They will also take a blood sample for assessment in the laboratory, If the doctor suspects leukemia they may suggest a bone marrow test, Bone marrow is taken usually from the hip using a long fine needle This can help to show which kind of leukemia if any is present.
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E. Spread Leukemia (Blood Cancer) Leukemia starts in the soft, inner part of the bones (bone marrow), but often moves quickly into the blood. It can then spread to other parts of the body, such as the lymph nodes, spleen, liver, central nervous system and other organs.
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E. staging Acute lymphoblastic: acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many immature lymphocytes (a type of white blood cell). Childhood acute lymphoblastic leukemia is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated, ALL is the most common type of cancer in children.
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E. staging Acute myelogenous : For patients treated with chemotherapy and radiation only leukemia CBC every one to two months for three years, then every three to six months for up to five years Echocardiography and electrocardiography every two years Radionuclide angiography or multiple-gated acquisition scan and Holter monitoring every five years For patients treated with HSCT Same as for patients with acute lymphoblastic leukemia Chronic lymphocytic : For patients being monitored without treatment leukemia Routine history for symptoms that would prompt treatment Routine physical examination, specifically evaluating for hepatosplenomegaly Periodic CBCs: lf progressive anemia or thrombocytopenia, refer to hematology Annual influenza vaccines Pneumococcal vaccination every five years Avoid live vaccines Age- and sex-specific cancer screening treated Referral to cardiologist for baseline evaluation Resting and stress echocardiography (frequency depending on baseline findings and other cardiac risk
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E. staging Chronic myelogenous : For patients treated with a tyrosine kinase inhibitor leukemia CBC every three months: If neutropenia (absolute neutrophil count 1,000 per l1.0 x 109 per Ll) or thrombocytopenia (platelet count <50 x 10 per ul 150 x 10 per Ll) refer to hematologist Monitor for adverse effects
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F. Treatment The treatment depends on the type and stage of the cancer, Some forms of leukemia grow slowly and don’t need immediate treatment, However treatment usually involves one or more type of treatment method depend on: 1- The type of leukemia. 2- The age of the patient. 3- Chromosomal (genetic) abnormalities. 4- Overall health of the patient. 5- The white cell counts. 6- The cancer cell's location. 7- The symptoms 8- The rate of disease progression.
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F. Treatment There are many different method of treatment: 1- Chemotherapy: is the main treatment for many kinds of leukemia, is the use of drugs to treat cancer, Chemo drugs attack cells that are dividing quickly, such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles. These cells are likely to be affected by chemo, which can lead to side effects.
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F. Treatment 2- Immunotherapy: Immunotherapy alert the immune system so the body can use its own natural defenses to fight the disease, Immunotherapy is sometimes used in addition to chemotherapy for patients with chronic lymphocytic leukemia (CLL), and it can also be an option for CLL patients who cannot undergo chemotherapy. There are different type of immunotherapy: Chimeric antigen receptor (CAR) T-cell therapy Cytokine treatment Donor lymphocyte infusion Monoclonal antibody therapy Radio-immunotherapy
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F. Treatment 3- Stem cell transplantation: Is a procedure that replaces unhealthy blood-forming cells with healthy cells. Stem cell transplantation allows doctors to give large doses of chemotherapy or radiation therapy to increase the chance of eliminating blood cancer in the marrow and then restoring normal blood cell production, There are different type of stem cell transplantation: Autologous: The stem cells come from a patient body. Allogeneic: The stem cells are from a healthy person (the donor). Reduced-intensity stem cell transplantation: Like allogeneic transplant, the stem cells are from a healthy person (the donor), but the chemotherapy given is less intensive.
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F. Treatment 4-blood transfusion: Blood transfusion using cells donated by healthy volunteers can help replace red cells, platelets and other blood components Some people with leukemia lymphoma myeloma and other blood diseases or disorders such as hereditary anemia's and aplastic anemia need periodic blood transfusions for several reasons: The disease process itself can sometimes interfere with the normal production of red cells, white cells and platelets in the bone marrow. For example, almost all patients with leukemia (which primarily affects the marrow and blood) require some transfusions during their care. Many chemotherapy drugs can temporarily impair blood cell production in the marrow and depress immune system functions. Stem cell transplantation patients receive high doses of chemotherapy, which depletes stores of normal blood cells.
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G. Radiation therapy in Leukemia: The radiation therapy is the use of ionizing radiation (x-rays) to damage the genetic material (DNA) inside tumor cells to prevent them from growing and reproducing and therefore die, a high-energy x-rays are delivered by a machine called linear accelerator -or 'linac' for short- to the tumor after precisely locate the site and size of the tumor and determine amount of dose required to kill that tumor and carefully sparing normal tissue. Radiation therapy in leukemia has many uses, although, usually it is not the main treatment, rather than a part of a treatment plan that includes chemotherapy or stem cell transplantation.
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G. Radiation therapy in Leukemia: Radiation therapy in general mostly used to kill the tumor, in the case of leukemia it is difficult to kill the tumors by radiation therapy due to the different locations of the bone marrow and blood, but it can be used to kill the tumor in case it has spread to other parts of the body, for example the brain or spinal cord. There are other different uses of radiation therapy in leukemia, it can be used to relieve patient discomfort caused by an enlarged liver, spleen or lymph nodes. Also it can be used to reduce pain from bone invaded by leukemia cells growing in the bone marrow.
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G. Radiation therapy in Leukemia: A different use of radiation therapy in leukemia is before stem cell transplant, it uses a method called TBI (total body irradiation) where the whole body is irradiated, it is often used as a preparation process for the patients to lower the immune system and make the body more acceptable to the stem cell being transplanted. There is an advanced form of TBI called TMI ( total marrow irradiation), it is the same principal as TBI, but it only focuses on the major marrow sites
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G. Radiation therapy in Leukemia: where the leukemia cells are located, it target the radiation dosage to the skeletal bone structure to help improve recovery time and reduce normal tissue exposure to radiation. The advantages of radiation therapy over chemotherapy is that it is a fast and painless procedure, in some cases it may only take a few minutes. Also, unlike chemotherapy, which circulate throughout the body, radiation therapy is often targeted to a specific area which help reduce the damage to healthy organs.
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References: References: https://www.lls.org/treatment/types-of-treatment https://www.healthline.com/health/leukemia#treatment http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/treatment/?region=sk https://www.cancer.org/cancer/acute-lymphocytic-leukemia/treating/chemotherapy.html https://www.cancersupportcommunity.org/immunotherapy-leukemia-and-lymphoma