Leukemia is a type of cancer which affects the blood cells. This entails the proliferation of abnormal immature white blood cells. These cells are accumulated in the lymphoid tissues and bone marrow, and when a person have leukemia it reproduce uncontrollably and infiltrate the body tissues and blood vessels. This will eventually lead to malfunction due to hemorrhage, encroachment, or infection. This can be further classified as acute, which is rapidly growing; or chronic, which develops more gradually.
Type of Leukemia
Acute – this type of leukemia entails a profound percentage of such immature cells and tends to progress rapidly if chemotherapy is not provided. In fact, the case of acute leukemia is already considered as a medical emergency, which would often require hospitalization and initiation of therapy within hours of the time and diagnosis is made.
Chronic – this condition has a lower percentage of immature cells and also have a significantly higher proportion of mature cells. Unlike acute type, this condition may progress slowly and may also not cause manifestations for years.
- The percentage of immature cells and the proportion of mature cells, determines the distinction between acute leukemia and chronic leukemia; instead of the number of abnormal cells found in the blood or the bone marrow.
Aside from acute and chronic leukemia, leukemia can be further identified as lymphocytic/ lymphoblastic or myelogenous.
Lymphocytic/ Lymphoblastic – affects the white blood cells referred as lymphocytes.
Myelogenous – affects the white blood cells referred as myelocytes.
Signs and Symptoms
- Loss of appetite
- Weight loss
- Bleeding gums
- Red spots on the skin
- Widespread bruising
- Frequent or severe nose bleeds
- Shortness of breath
- Rapid heartbeat
- Frequent infections
- Cold sores
- Urinary tract
- Infection in the anal area
- Sore throat
- Bone or joint pain
- Night sweats
- Swelling of the testicles
- Vision problems
- Abdominal discomfort or feeling of fullness
- Bone or joint pain
- Enlarged lymph nodes
- Stem cell transplant: an option is recommended for patient age 55 years old.
- Chemotherapy: this option is often the main treatment for patients with leukemia and other forms of cancer.
- Radiation therapy: most often use in preventing spread to the central nervous system as well as for treating the disease per se; and to prepare for stem cell transplant.
- Targeted therapy: a treatment used for patients with Philadelphia treatment.
- Supportive therapy: an intervention used for managing complications of treatment.
Supportive Care for Leukemia
Fatigue: this is a known symptoms when a patient have a low red blood cells, and this may require blood transfusion.
Infection: this develops due to low white blood cell count (neutropenia). Neutropenia is brought about by malfunction of bone marrow, or could be an effect of the chemotherapy treatment. Medications used for this symptoms are antibiotics and antifungal.
Abnormal bleeding: this transpire due to low platelet count. This is also brought about by malfunction of bone marrow, or could be an effect of the chemotherapy treatment. The treatment provided for this symptom is platelet transfusion to help slow or reduce bleeding.
Loss of appetite: this is a common symptoms for patients with leukemia, and it could result from the disease per se, fatigue or depression, and treatments.
Emotional health: during treatment, the patient may experience vast array of overwhelming emotions. Unexpected feelings or thoughts felt by the patients may include the following:
- Adapting to lifestyle
- Concern that the cancer will come back
- Thinking about the possible effects of cancer to them, their family, friends, work, and other significant others.
- Anxiety due to less contact with the health care team
- Questioning self- worth, identity, and alterations in appearance
Carcinoembryonic antigen (CEA): May be elevated.
Cold agglutinins: May be elevated (more than 1:16) in lymphatic leukemia.
Cryoglobulins: Positive cryoglobulin findings may be present in patients with lymphocytic leukemia.
CBC: Indicates a normocytic, normochromic anemia.
Hemoglobin: May be less than 10 g/100 mL.
Reticulocytes: Count is usually low.
Platelet count: May be very low (less than 50,000/mm).
WBC: May be more than 50,000/cm with increased immature WBCs (“shift to left”). Leukemic blast cells may be present.
Prothrombin time (PT)/activated partial thromboplastin time (aPTT): Prolonged.
LDH: May be elevated.
Serum/urine uric acid: May be elevated.
Serum muramidase (a lysozyme): Elevated in acute monocytic and myelomonocytic leukemias.
Serum copper: Elevated.
Serum zinc: Decreased.
Bence Jones protein (urine): Increased.
Bone marrow biopsy: Abnormal WBCs usually make up 50% or more of the WBCs in the bone marrow. Often 60%–90% of the cells are blast cells, with erythroid precursors, mature cells, and megakaryocytes reduced.
Chest x-ray and lymph node biopsies: May indicate degree of involvement.
- Prevent infection during acute phases of disease/treatment.
- Maintain circulating blood volume.
- Alleviate pain.
- Promote optimal physical functioning.
- Provide psychological support.
- Provide information about disease process/prognosis and treatment needs.