1.

Make a table to differentiate the 4 common types of leukemia: Acute lymphocytic leukemia
(ALL), Chronic lymphocytic leukemia (CLL), Acute myeloid leukemia (AML), and Chronic
myeloid leukemia (CML) according to incidence, physiologic alterations, clinical manifestations,
management, and prognosis
Acute Chronic Chronic Myeloid Chronic Myeloid
Lymphocytic Lymphocytic Leukemia (AML) Leukemia (CML)
Leukemia (ALL) Leukemia (CLL)

Incidence The average A US study AML is About 15% of all

person’s lifetime published in uncommon, leukemia is
risk of getting 2004 estimates making up about CML. This year,
ALL is about 1 in the worldwide 1% of cancers. an estimated
1,000. The risk incidence of CLL This year, an 9,110 people
is slightly higher to be between estimated (5,150 men and
in males than in <1 and 5.5 per 20,240 people of 3,960 women) in
females and 100,000 people all ages (11,230 the United
higher in whites (24). The men and boys Stated will be
than in African highest and 9,010 diagnosed with
Americans. Most incidence rates women and CML. Most of
cases of ALL in 2004 were girls) in the these will be
occur in found to be in United States adults, with an
children, but Australia, US, will be average age of
most deaths Ireland and Italy diagnosed with diagnosis of 64
from ALL (about AML. AML is the years. About
4 out of 5) occur second most 50% of cases
in adults. common type of are found in
leukemia people older
diagnosed in than 64
adult and
children but
most cases
occur in adults

Physiologic Acute Chronic (AML). In CML is a stem

Alterations Lymphocytic Lymphocytic myeloid cells, cell disease
Leukemia Leukemia is the myeloblast is characterized by
occurs as a distinguished by an immature the
bone marrow the clonal reservoir of accumulation of
cell makes DNA proliferation of white blood myeloid
mistakes. The CD5+ CD23+ B cells. This precursor cells
errors instruct Cells in the myeloblast may in the bone
the cell to begin blood, bone experience a marrow and
expanding and marrow and genetic blood. This cells
splitting while a secondary alteration that exhibits a
stable cell will lymphoid tissues prevents the cell distinct
normally avoid (CLL). Gene from maturing abnormality in
dividing and expression and the gene
eventually die. profiling and differentiating encoding the
As a result, phenotypic tests translocation of
 blood cell growth indicate that CLL chromosomes 9
becomes is likely and 22
abnormal. originated from
CD5+ B cells
similar to those
found in healthy
adult blood

Clinical •Felt exhausted •Deficiency •Fatigue •Defects

Manifestation •Suffering from •Exhaustion •Defects •Exhausted
nausea •Loss of weight • Feeling cold •Perspire at
•Experienced •The chills High •Experienced night
•lightheadednes fever Sweating lightheadedness •Weight loss
•Lack of breath at night or dizziness •Bone ache
•A thin peel •Enlarged lymp •Lack of breath (caused by
•Chronic nodes (often felt leukemia cells
diseases that do as lumps under that migrate
not resolve or do the skin) from the marrow
not recur •Abdominal pain cavity to the
•Surface or a feeling of bone surface or
bruishing (with “fullness” into the joint)
little red or •Spleen
purple spots); enlargement
•Bleeding, such (feeling as a
as frequent or mass below the
severe feminine left side of the
nosebleeds, ribcage)
bleeding gums
or menstrual
bleeding that is
excessive

Managements Treatments may If your doctor Treatment The standard

include: determines your depends on the treatment for
Chronic subtype of AML chronic phase
Chemotherapy, Lymphocytic and may include CML is a
which uses Leukemia is the following: tyrosine kinase
drugs to kill progressing or is inhibitor (TKI)
cancer cells, is in the •Combination like imatinib
typically used as intermediate or chemotherapy (Gleevec),
an induction advanced •Targeted nilotinib
therapy for stages, your therapy with (Tasigna),
children and treatment monoclonal dasatinib
adults with options may antibodies (Sprycel), or
Acute include: •Stem cell bosutinib
Lymphocytic transplant using (Bosulif).
Leukemia. Chemotherapy. the patient’s
Targeted drug. stem cells or If the first drug
Immunotherapy. donor stem cells stops working or
Bone marrow •Arsenic trioxide it never really
transplant therapy worked well at
• A clinical trial all, the dose
of arsenic may be
trioxide therapy increased or
followed by stem another TKI
cell transplant might be tried
2. Formulate a Nursing Care Plan for a patient with Acute Leukemia
NCP:ACUTE LEUKEMIA

Nursing Nursing Background Nursing Nursing Rationale Evaluation

Assessme Diagnosis Knowledge Planning Intervention
nt

Subjective: Risk for Leukemias After 6 Independent Independent: After 6

“Nagkaka infection are cancer of hours of Place the Protect patient hours of
pasa po ako related to the blood nursing patient in a from potential nursing
nang hindi deficient forming interventi private room. sources interventio
ko alam at primary tissues. on s the Limited pathogens or n s the
biglaan po defenses White blood patient visitors as infection patient was
ako cells may be will: indicated. able to:
nangayayat produced in identify Prohibits use identify
” as excessive actions to of live plants actions to
verbalized amounts and prevent or cut prevent or
by the are unable to or reduce flowers. reduce the
patient work properly the risk Restrict fresh risk for
which for fruits and infection
Objective: weakens the infection vegetables or
•Skin pallor immune make sure
•Irritability system they are
washed or
T:37.5 peeled
P:80
R:18 Require good Prevent cross
BP:110/80 hand examination
washing or reduce risk
protocol for for infection
all personnel
and visitors

Encourage Prevent stasis

frequent of respiratory
turning and secretions,
deep reducing risk
breathing of atelectasis
or pneumonia

Inspect skin May indicate

for tender local infection
erythematous
ares, open
wounds,
Cleanse skin
with
antibacterial
solutions
Promote Promotes
good perineal cleanliness,
hygiene. reducing risk
Examine of perianal
perianal area abscess;
at least daily enhances
during acute circulation and
illness and healing.
provide sitz Conserves
baths energy for
healing,
cellular
regeneration