Leukemia
Terms
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- How is leukemia classified/
- course of disease & cell inlvoved
- What is the course of most adult leukemia? (acute or chronic)
- chronic
- Bone marrow produces young, undifferentieated cells; often called , blasts in chronic or acute leukemia
- acute leukemia
- Bone marrow produces differentiated mature WBC but non-functioning , in acute or chronic leukemia?
- chronic
- Etiology of leukemia can be exposure to chemicals such as [..] or , chemotherapy
- benzene
- Etiology of leukemia can be exposure to chemicals such as benzene or , [..]
- chemotherapy
- Majority of leukemia in adults (89%) is what type?
- actue nonlymphblastic leukemia (ANLL)
- Actue nonlymphoblastic leukemia (ANLL) is also called?
- actue myelogenous
- Age of peak incidence of ANLL (acute nonlymphoblastic leukemia) is?
- 60-70
- Age of peak onset of chronic myelogenous leukemia?
- 45
- leukemia w/clinical manisfestions: mouth sores & minimal , lymphadenopathy
- ANLL (actue nonlymphoblastic leukemia) / actue myelogenous
- leukemia w/clinical manifestations of: massive spenomegaly, , incrased sweating, bone pain
- chronic myelogenous leukemia
- Leukemia which will have the presensce of philadelphia chromosome?
- chronic myelogenous leukemia
- What is a complication seen with chronic myelogenous , leukmia?
- Blast Crisis
- What is blast crisis, which may be seen in chronic myelogenous , leukemia?
- change from chronic to acute condition
- What treatment is recommended during a blast crisis
- pt is refractory (unresponsive) to treatment
- This leukema has no early symptoms & usually detected in , examination , for unrelated conditions?
- chronic lymphocytic leukemia
- this leukemia has an age of onset between 50-70 and a predominance , in men?
- chronic lympocytic leukemia
- intial goal of treatment for leukemia?
- remission
- no evidence of disease (NED) on exam & bone maorrow & peripheral , blood appear normal is what type remission?
- complete remission
- remission characterized by no overt clinical disease & normal , peripheral blood smear but evidence of disease is in the bone marrow?
- partial remission
- What's the goal of chemo given to a BMT pt?
- destroy bone marrow including stem cells
- what type of pt would recieve chemo with the purpose of destroying , their bone marrow including stem cells?
- BMT (bone marrow transplant)
- How is a bone marrow transplant infused?
- like blood through a central line
- What are the 3 types of bone marrow transplants?
- allogenic, autologus & syngenic
- This type of bone marrow transplant is usually from a sybling and is , HLA (human leukocyte antigen) matched to make sure it , histocomaptible?
- allogenic
- This type of bone marrow transplant is from one's own marrow , harvested during remission
- autologous
- This type of bone marrow transplant is from an indential twin?
- syngeneic
- About how long does it take before transplanted bone marrow starts , to produce cells?
- 2-4 weeks
- What may be given during the first few weeks after marrow transplant , while waiting for the marrow to being producing cells?
- growth factors
- What is the stage called after tarnsplant but before the bone marrow , begins to produce cells?
- engraphment
- A pt will start to feel better shortly after a bone marrow transplant , <T/F>
- false, still at risk of dying during entrampment phase, (waiting for , marrow to being producing cells)
- How is doner blood for peripheral stem cell trasplantation , collected?
- pheresis
- What component of the blood is taken from the doner for , peripheral stem cell transplant (the rest of the blood is , returned to the doner)?
- stem cells
- Which pt recoves quicker, bone marrow or peripherial stem cell , transplant?
- periherial stem cell transplant (PSCT)
- What is a potential added bonus of recieving a peripheral stem cell , transplant
- donated stem cells may attack remaing cancer cells
- What is the only type of transplant that graft vs host disease (GVHD) , can occur?
- allogenic
- This condition can occur when a immunoincompetent pt is infused with , immunocometent cells
- GVHD (graft vs host disease)
- this reaction can occur when an infsuion of any blood product is given , & cotnains viable lymphocytes?
- GVHD (graft vs host disease)
- Which cell initiates an immun respone to the tissues of the recipient, , cause GVHD?
- T lymphocyte
- What symptom may be seen with the skin in GVHD?
- puritic rash (maybe painful)
- What happens to liver enzymes with GVHD?
- elevated
- What can be done to the blood to prevent GVHD?
- remove donor T-cells
- What can meds can be given to pt during engraphment period to , prevent GVHD (3 meds)
- prednisone &/or cyclosprine & methotrexate
- Pt may be on this med for up to a year following marrow transplant to , avoid GVHD?
- cyclosporine
- When might you be looking for GVHD to occur, post-transplant
- 7-30 days
- Why would you radiate cells prior to transpant (for prevention of , GVHD)?
- prevent t-cell replication
- Each time there is a relapse the succeeding [..] may be more , difficult to , achieve & shorter in duration?
- remission
- 4 phases/stages of chemotherapy
- induction, intensification, consolidation, maintenance
- during this phase of chemotherapy the goal is to induce a remission?
- induction
- During this phase of chemotherapy high dose drugs are given for , several months
- intensification
- When is the intensification phase of chemotherapy begun?
- immediatley after induction therapy
- Goal during this phase of chemotherapy is to eleiminate remaining , leukemic cells?
- consolidation
- During this phase of chemotherpay drugs are given every 3-4 weeks , and may last for years
- maintenace
- The goal of this phase of chemotherapy is to maintain remission?
- maintenance
- This leukemia can have high or low WBC with myeloblasts?
- ANLL (actue non-lympoblastic leukemia) / acute myelogenous