LEUKEMIA PHINMA-UPANG

Prof: Leonardo R. Sanchez IV, RN CHS Batch 2024

Adapted from: PowerPoint/Lecture NUR 155 (MS LEC)
Transcribed by: Julia Rae Delos Santos (3BSN-12) September 13, 2022

RISK FACTORS FOR LEUKEMIA

▪ Previous cancer treatment
What is LEUKEMIA? ▪ Genetic disorders
▪ Exposure to certain chemicals
▪ Smoking
• Leukemia is a cancer of ▪ family history of leukemia
the body’s blood-forming
tissues, including the
bone marrow and the PATHOPHYSIOLOGY
lymphatic system. Scientists don’t understand the exact causes of
• Many types of leukemia leukemia. It seems to develop from a combination of
exist. Some forms of genetic and environmental factors.
leukemia are more
How leukemia forms
common in children.
Other forms of leukemia o In general, leukemia is thought to occur when
occur mostly in adults. some blood cells acquire mutations in their DNA
• Leukemia usually involves – the instructions inside each cell that guide its
the white blood cells. action. There may be other changes in the cells
Your white blood cells are that have yet to be fully understood that could
potent infection fighters – contribute to leukemia.
they normally grow and o Certain abnormalities cause the cell to grow and
divide in an orderly way, divide more rapidly and to continue living when
as your body needs them. normal cells would die. Over time, these
abnormal cells can crowd out healthy blood
But in people with
cells in the bone marrow, leading to fewer
leukemia, the bone
healthy white blood cells, red blood cells, and
marrow produces
platelets, causing the signs and symptoms of
abnormal white blood
leukemia.
cells, which don’t function
properly. How is Leukemia classified?
• Treatment for leukemia Doctors classify leukemia based on its speed of
can be complex – progression and the type of cells involved.
depending on the type of
leukemia and other The first type of classification is by how fast the
factors. But there are leukemia progresses:
strategies and resources Acute Leukemia Chronic Leukemia
that can help to make In acute leukemia, There are many types of
your treatment the abnormal blood chronic leukemias. Some
successful. cells are immature produce too many cells and
blood cells (blasts). some cause too few cells to be
They can’t carry out produced.
their normal
functions, and they Chronic leukemia involves
multiply rapidly, so more mature blood cells.
the disease worsens These blood cells replicate or
quickly. accumulate more slowly and
can function normally for a
Acute leukemia period of time.
requires aggressive,
timely treatment. Some forms of chronic
leukemia initially produce no
early symptoms and can go
unnoticed or undiagnosed for
years.

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 LEUKEMIA PHINMA-UPANG
Prof: Leonardo R. Sanchez IV, RN CHS Batch 2024
Adapted from: PowerPoint/Lecture NUR 155 (MS LEC)
Transcribed by: Julia Rae Delos Santos (3BSN-12) September 13, 2022

The second type of classification is by type of white ASSESSMENT FINDINGS

blood cell affected:
Subjective cues Objective cues
Lymphocytic leukemia Myelogenous leukemia ❖ Fatigue ❖ Unexplained
This type of leukemia This type of leukemia ❖ Loss of appetite weight loss due to
affects the lymphoid cells affects the myeloid cells. ❖ Generalized the caloric needs of
(lymphocytes), which Myeloid cells give rise to weakness the tumor, taking
form lymphoid or red blood cells, white ❖ Bone pain or away from the
lymphatic tissue. blood cells and platelet- tenderness needs of the body.
Lymphatic tissue makes producing cells. ❖ Anorexia
up your immune system. ❖ Fever or chills
❖ Frequent or severe
infections
❖ Swollen lymph
nodes, enlarged
liver or spleen
❖ Easy bleeding or
bruising
❖ Recurrent
nosebleeds
❖ Petechiae
❖ Excessive sweating,
especially at night

Special Notation

❖ Stem cell transplant

❖ Oxygen therapy prn
❖ High calorie, high fiber diet
❖ Low fat, low protein diet

Types of Leukemias
Acute lymphocytic leukemia (ALL). This is the most
common type of leukemia in young children. ALL can
also occur in older adults.
Acute myelogenous leukemia (AML). AML is
common type of leukemia. It occurs in children and
adults. AML is the most common type of acute
leukemia in adults.
Chronic lymphocytic leukemia (CLL). With CLL, the
most common chronic adult leukemia, you may feel
well for years without needing treatment.
Chronic myelogenous (CML). This type of leukemia
mainly affects adults. A person with CML, may have
few or no symptom for months years before entering
a phase in which the leukemia cells grow more
quickly.
Other types. Other, rarer types of leukemia exist,
including hairy cell leukemia myelodysplastic
syndromes and myeloproliferative disorders.
Laboratory Diagnostic Examinations
❖ Physical exam, noting enlargement of lymph
nodes, liver and spleen, pale skin from anemia
❖ Complete blood count (CBC) and WBC
differential
❖ Blood smear or peripheral blood smear
❖ CT scan to check for metastasis
❖ Spinal tap (lumbar puncture) and
cerebrospinal fluid analysis
❖ Immunophenotyping or phenotyping by flow
cytometry and/or immunohistochemistry
❖ Cytogenic tests (FISH and karyotyping)
❖ Molecular testing

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 LEUKEMIA PHINMA-UPANG
Prof: Leonardo R. Sanchez IV, RN CHS Batch 2024
Adapted from: PowerPoint/Lecture NUR 155 (MS LEC)
Transcribed by: Julia Rae Delos Santos (3BSN-12) September 13, 2022

MEDICATIONS
Patient Teaching

Chemotherapy before using surgery to shrink for Patients with Leukemia

some tumors, or after surgery: To prevent infection:
● cyclophosphamide ▪ Avoid eating raw foods
▪ Avoid going to public places
● methotrexate ▪ always wear a mask when going out
● fluorouracil ▪ avoid people with obvious infections

● epirubncin To prevent bleeding:

▪ avoid contact sports
● vincristine ▪ always wear shoes or slippers at all times
● paclitaxel ▪ use an electric shaver
▪ cut nails across
● docetaxel ▪ avoid handling sharp objects
Administer analgesics for pain control:

● morphine, fentanyl

● tyrosine kinase inhibitors and anti-leukemia

antibodies