Leukemia

• Leukemia is a malignant increase in the number of leukocytes, usually at an immature stage, in the bone marrow
• ALL (acute lymphocytic leukemia) is most common in children, with peak incidence between ages 2 and 9. It is often cured with chemotherapy alone.
• In leukemia, the primary problem is proliferation of immature WBCs, which depresses the bone marrow. The client becomes immunocompromised.
• Leukopenia: Signs and symptoms

  • There is decreased production of RBCs and platelets. RBC = anemia; Platelets = thrombocytopenia
  • Hypertrophy of the bone marrow causes bone pain
  • Organ infiltration by immature WBC (hepatomegaly, splenomegaly)
  • Hepatosplenomegaly = abdominal pain
  • Tumor lysis syndrome (rapid destruction of large numbers of malignant cells) = hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia
• Leukemia: Management

  • Chemotherapy
  • Bone marrow transplantation
  • Blood transfusion
  • Allopurinol to prevent tumor lysis syndrome
  • Bleeding precaution
  • Infection precaution