Leukemia Pathophysiology

Non Modifiable Factors:

 exposure to radiation
Modifiable
ETIOLOGY: and certain chemicals
Factors:
Unknown  having a sibling with
Age leukemia
Gender  HTLV-1 virus
Race  genetic abnormalities
Family History
Somatic mutations in  chromosomal
the DNA translocations

Activate oncogene/
deactivate tumor-
suppressor gene

Malignant transformation
of lymphoid stem cells

s/sx:
Uncontrolled proliferation bone pain Treatment:
of lymphoblast in the bone joint pain Analgesic
marrow

Diagnostic Treatment:
Test: Lymphoblast replace the  Remission
BM aspiration normal marrow elements Induction Therapy
BM biopsy  Consolidation and
Maintenance
Therapy
 BM Transplantation
 CNS prophylaxis
 Diagnostic Leukopenia Decreased production of s/sx: Treatment:
Test: normal blood cells  presence of  Blood
(↓4.36 x 10 9/L)
CBC petechiae transfusion
Decreased production  bruise & bleed  Epoetin and
of normal blood cells easily hemapoetic
 anemia stimulants
Spillage of lymphoblast
s/sx: Infection  fatigue
into the bloodstream
fever, chills  dizziness
seizure  palpitations
 dyspnea

Organ infiltration
If treated: If not treated
Antibiotic
Ig
Leukapheresis
Septicemia

Prevention of Death
complications

Diagnostic CNS
Kidneys Test:
s/sx: Liver / Diagnostic
MRI
s/sx: h/a, weakness, blurred Spleen Test:
 Little/ no UO vision, balance difficulty, Ultrasonography
Renal failure  ↑RR Treatment: leukocyte cells vomiting, lethargy
 Flank pain Intrathecal impairs the
 Restless Extra cells
chemotherapy circulation of
 n/v cause the
CSF s/sx: s/sx:
 legs and liver/spleen
↑ CSF hepatomegaly
feet swelling to rupture
leukocytes splenomegaly
 uremia
Diagnostic elevated ALT
 azotemia leukocyte cells (81 u/L)
Test:
compresses s/sx: bleeding
Spinal Tap
spinal/ cranial cranial nerve palsies
nerves confusional states
optic neuropathy Hypovolemic s/sx:
cerebellar dysfunction shock hypotension
papilledema tachypnea
Progress to coma
tachychardia
 Physical
Overgrown s/sx: Exam Lymph
thymus shortness of Diagnostic nodes
breath test:
cough Lymph node
suffocation biopsy
Compress Mediastinal
the Superior lymphadenopathy
Vena Cava
s/sx:
lymphadenopathy
Bronchial/tracheal
SVC syndrome obstruction

Treatment: s/sx:
s/sx:  O2 cough, wheezes, Esophageal
 swelling of administration respiratory tract compression
head, neck and  Bronchodilators obstruction
arms
 obstruction of
blood flow Erosion of node
s/sx: into a bronchus/
dysphagia trachea

s/sx: Severe
hemoptysis hypoxia

DEATH