منتدى ملائكه الرحمه
مرحبا بك زائرنا العزيز فى منتديات ملائكة الرحمه و نرجو منك الأنضمام لكوكبة المنتدى المميزه

منتدى ملائكه الرحمه


 
الرئيسيةالبوابةقائمة الاعضاءالمجموعاتالتسجيلدخول

شاطر | 
 

 Leukemia ...

استعرض الموضوع السابق استعرض الموضوع التالي اذهب الى الأسفل 
كاتب الموضوعرسالة
رشروشه
Admin
Admin


انثى عدد الرسائل : 4030
العمر : 28
العمل/الترفيه : المدير
السٌّمعَة : 4
نقاط : 982
تاريخ التسجيل : 02/04/2008

مُساهمةموضوع: Leukemia ...   الثلاثاء 08 أبريل 2008, 19:32

Leukemia
Introduction
Leukemia is cancer of blood-forming
tissues, including the bone marrow and lymphatic system. The word "leukemia"
means "white blood" in Greek. The disease usually starts in the white blood
cells.
Under normal circumstances, white blood cells are potent infection
fighters. These cells normally grow and divide in an orderly, controlled way, as
body needs them. But leukemia disrupts this process
In leukemia, bone marrow
produces a large number of abnormal white blood cells. They look different from
normal blood cells and don't function properly. Eventually, they block
production of normal white blood cells, impairing ability to fight off
infection. Leukemia cells also crowd out other types of blood cells produced by
the bone marrow, including red blood cells, which carry oxygen to tissues
throughout body, and platelets, which help form blood clots
Leukemia isn't
just a children's disease, as some people think. Leukemia has four main types
and many subtypes — and only some of them are common among children. Treatment
of leukemia is complex — and it depends on age and health, the type of leukemia
and how far it has spread
Signs and symptoms
Signs and symptoms for
each type of leukemia differ, but common symptoms include Fever or chills

Persistent fatigue, weakness
Frequent infections
Loss of appetite or
weight
Swollen lymph nodes, enlarged liver or spleen
Easy bleeding or
bruising
Shortness of breath when physically active, as while climbing steps

Tiny red marks in your skin (petechiae)
Excessive sweating, especially
at night
Bone pain or tenderness
The severity of signs and symptoms
depends on the number of abnormal blood cells and where they collect. May
overlook early symptoms of leukemia because they may resemble symptoms of the
flu and other common illnesses


Causes
Doctors classify
leukemia in two ways
Speed of progression
The first type of classification
is by how fast the leukemia progresses
Acute leukemia. In acute leukemia, the
abnormal blood cells are immature blood cells (blasts). They can't carry out
their normal work, and they multiply rapidly, so the disease worsens quickly.
Acute leukemia requires aggressive, timely treatment.
Chronic leukemia. This
type of leukemia involves more mature blood cells. These blood cells replicate
or accumulate more slowly and can function normally for a period of time. Some
forms of chronic leukemia produce no signs or symptoms and can go unnoticed or
undiagnosed for years
Types of cells affectes
The second type of
classification is by type of white blood cell affected
• Lymphocytic
leukemia. This type of leukemia affects the lymphoid cells or lymphocytes, which
form lymphoid or lymphatic tissue. This tissue is the main component of the
immune system and is found in various places throughout your body, including
lymph nodes, spleen and tonsils
Myelogenous (MI-uh-loj-uh-nus) leukemia. This
type of leukemia affects the myeloid cells. The myeloid cell line includes cells
that later develop into red blood cells, white blood cells and
platelet-producing cells.
Major types
The major types of leukemia
are
Acute myelogenous leukemia (AML). This is the most common type of
leukemia. It occurs in children and adults. It's also called acute
nonlymphocytic leukemia
Acute lymphocytic leukemia (ALL). This is the most
common type of leukemia in young children. ALL accounts for 80 percent of all
childhood leukemias
Chronic lymphocytic leukemia (CLL). With CLL, a common
adult leukemia, you may feel well for years without treatment. CLL is more
common in Jewish people of Russian or Eastern European descent. It almost never
affects children
Chronic myelogenous leukemia (CML). This type of leukemia
mainly affects adults. It's associated with a chromosome abnormality called the
Philadelphia chromosome, which creates an abnormal gene called BCR-ABL. The
BCR-ABL gene produces an abnormal protein called tyrosine kinase that doctors
and researchers believe causes leukemia cells to grow and develop. A person with
CML may have few or no symptoms for months or years before entering a phase in
which the leukemia cells grow more quickly
Other chronic myeloid disorders.
Like CML, this group of diseases causes chronic leukemia by the creation of too
few or too many myeloid cells. Chronic myeloid disorders include myelodysplastic
syndromes and myeloproliferative disorders such as essential thrombocythemia,
polycythemia vera and myelofibrosis. These conditions may lead to acute myeloid
leukemia
Other, rarer types of leukemia include hairy cell leukemia and
chronic myelomonocytic leukemia
Causes unclear
Doctors don't understand
the exact cause of leukemia. It seems to develop from a combination of genetic
and environmental factors
Acute leukemia begins with one or a few white blood
cells that have a lost or damaged DNA sequence. These cells remain immature in
what's known as a blast form, but maintain the ability to multiply. Because they
don't mature and then die as normal cells do, they accumulate and begin to
interfere with functions of vital organs. Eventually, they overwhelm the
production of healthy cells.
Chronic leukemia involves more mature blood
cells. They replicate and accumulate more slowly, so the progression of the
disease is slower but it can still be deadly. Experts aren't sure why this
process begins
Eventually, a shortage of normal white blood cells leads to
infection, anemia and excessive bleeding. Too many abnormal white blood cells
can impair the function of bone marrow and infiltrate other organs. Death
usually results from bleeding or infection.
Risk factors
These
factors place you at an increased risk of developing some types of
leukemia
Cancer therapy. People who've had certain types of chemotherapy and
radiation therapy for other cancers have a slightly greater risk of developing
certain types of leukemia many years later
Genetics. Genetic abnormalities
seem to play a role in the development of leukemia. Certain genetic diseases,
such as Down syndrome, are associated with increased risk of
leukemia
Exposure to radiation and certain chemicals. People exposed to very
high levels of radiation, such as survivors of an atomic bomb blast or a nuclear
reactor accident, have an increased risk of developing leukemia. Exposure to
certain chemicals, such as benzene — which is found in unleaded gasoline and
tobacco smoke and used by the chemical industry — is also linked to greater risk
of some kinds of leukemia.
However, most people with known risk factors
don't get leukemia. And many people with leukemia have none of these risk
factors
When to seek medical advice
Persistent fatigue, weight
loss, easy bruising, bleeding, swollen lymph glands and fever are possible
indications of leukemia. If any person have these signs or symptoms, see doctor
to determine the underlying cause
Screening and
diagnosis


Doctors often find chronic leukemia in a routine blood
test, before symptoms begin. If this happens, or if child has symptoms that
suggest leukemia, may undergo the following diagnostic exams
Physical exam.
doctor will look for physical signs of leukemia, such as pale skin from anemia
and swelling of your lymph nodes, liver and spleen
Blood tests. By looking
at a sample of blood, doctor can determine if patients have abnormal levels of
white blood cells or platelets — which may indicate leukemia
Cytogenetic
analysis. This test detects changes in the chromosomes, including the presence
of the Philadelphia chromosome. It can be done using a regular microscope or a
more modern lab technology called fluorescence in situ hybridization
(FISH)
Bone marrow sample. If doctor suspects leukemia, he or she may refer
you to a doctor who specializes in cancer (oncologist) or a doctor who
specializes in blood (hematologist). This specialist can use a needle to remove
a sample of bone marrow to look for leukemia cells.
Patients will need
additional tests to confirm the diagnosis and to determine the type of leukemia
and its extent in the body. Certain types of leukemia are classified into
stages, indicating the severity of the disease. Staging helps doctor determine a
treatment plan.

Treatment
Unlike other types of cancer,
leukemia isn't a solid tumor that your doctor can surgically remove. The source
of the problem is really the bone marrow. But you can't just remove bone marrow
because it produces three basic types of cells — white blood cells, red blood
cells and platelets
Treatment for leukemia is complex. It depends on many
factors, including age and overall health, the type of leukemia that patients
have and whether it has spread to other parts of the body
Therapies used to
fight leukemia include
Chemotherapy. Chemotherapy is the major form of
treatment for leukemia. This treatment uses chemical agents to kill leukemia
cells. Depending on the type of leukemia, patients may receive a single drug or
a combination of one or more drugs. These drugs may come in a pill form, or they
may be injected directly into a vein
Biological therapy. Also known as
immunotherapy, biological therapy uses substances that bolster the immune
system's response to cancer
Kinase inhibitors. For most people with CML, the
drug imatinib mesylate (Gleevec) is the first line of therapy. Imatinib mesylate
is a type of cancer drug called a kinase inhibitor. It was specifically
developed to inhibit the BCR-ABL protein, and it has proved effective in
treating the early stages of chronic myelogenous leukemia. Several newer kinase
inhibitors are in development
Other drug therapy. Arsenic trioxide and
all-trans retinoic acid (ATRA) are anti-cancer drugs that doctors can use alone
— or in combination with chemotherapy — to treat a certain subtype of AML called
promyelocytic leukemia. These drugs cause leukemia cells with a specific gene
mutation to mature and die
Radiation therapy. Radiation therapy uses X-rays
or other high-energy rays to damage leukemia cells and stop their growth.
patients may receive radiation in one specific area of your body where there is
a collection of leukemia cells, or patients may receive radiation directed at
your whole body
Bone marrow transplant. This process replaces leukemic bone
marrow with leukemia-free marrow. In this treatment, patients receive high doses
of chemotherapy or radiation therapy, which destroys leukemia-producing blood
marrow. This marrow is then replaced by bone marrow from a compatible donor. In
some cases, patients may also be able to use your own bone marrow for transplant
(autologous transplant). This is possible if you go into remission and then save
healthy bone marrow for a future transplant, in case the leukemia
returns
Stem cell transplant. Stem cell transplant is similar to bone marrow
transplant except the cells are collected from stem cells that circulate in the
bloodstream (peripheral blood). The cells used for transplant can be your own
healthy cells (autologous transplant), or they can be collected from a
compatible donor (allogeneic transplant). Doctors use this procedure more
frequently than bone marrow transplant because of shortened recovery times and
possible decreased risk of infection
Clinical trials. Some people with
leukemia choose to enroll in clinical trials to try out experimental treatments
or new combinations of known therapies
• Supportive care. No matter what kind
of cancer therapy patients choose, patients will likely need medications to
control pain and side effects.

_________________




الرجوع الى أعلى الصفحة اذهب الى الأسفل
معاينة صفحة البيانات الشخصي للعضو http://nursing.goo-done.com
 
Leukemia ...
استعرض الموضوع السابق استعرض الموضوع التالي الرجوع الى أعلى الصفحة 
صفحة 1 من اصل 1

صلاحيات هذا المنتدى:لاتستطيع الرد على المواضيع في هذا المنتدى
منتدى ملائكه الرحمه :: المنتدى التمريضى :: تخصصات التمريض :: تمريض الامراض السرطانيه Oncology Nursing-
انتقل الى: