Pt undergoes extensive course of chemo to kill the cancer cells-dangerous level for pt-then donor marrow cells are given to pt to reestablish new stem cells o Radiation therapy Use of x-rays to kill CA cells-directed at CA site-kills normal cells also-inflammation of surrounding cells Side effects: inflammation of surrounding cells (ex: esophageal radiation causes patient to lose voice, ability to swallow, etc.) o Gene therapy Transplant new genes-more receptive to chemo WBC disorder terms o Leucopenia- in WBCs o Neutropenia- in neutrophils < 1500 cells/uL agranulocytosis-severe- <200 cells/uL “shift to the left”-immature neutrophils o thrombocytopenia- in platelets normal=150,000-450,000 necessary for clotting neutropenia o in neutrophils o occurs rapidly-neutrophil lives only 1 day o Pathophysiology use/uptake of neutrophils-inflammation and infection rx induced wipes out bone marrow production of stem cells dose of rx-thorazine (tranquilizer), sulfonamides, dilantin (long term seizure tx) neoplasms-cause CA cells to replace bone marrow stem cells, leukemias and lymphomas o S&S Malaise Chills and fever Weakness to extreme fatigue Ulcerations of mouth-stomatitis, skin, vagina, GI tract o Dx Leucopenia- WBCs- <1000/uL, severe-200-300/uL Normal WBC = 5,000-10,000 Neutropenia- in neutrophils- <1,500 cells/uL Agranulocytosis- severe neutropenia <200 cells/uL o Complications Infections (neutrophils important in inflam response) Pt susceptible to “common” organisms on skin, GI tract Bacteria (staph, strep), Fungi Resp tract is target area Septicemia/sepsis-can be fatal
o Tx Antibiotics Hematopoietic growth factors Purpose to stimulate growth of stem cells to mature CSF-colony stimulating factors-interleukin and interferon Leukemias o Pathophysiology Malignant CA cells take over in cell division and differentiation of the stem cell in bone marrow- production of abnormal cells Abnormal cell production effects lymphocytes and myelocytes Abnormal cells have life span and proliferation o Acute leukemias ALL-acute lymphocytic leukemia AML-acute myelocytic leukemia o Chronic leukemias CLL=chronic lymphocytic leukemia CML-chronic myelocytic leukemia o Causes Unknown Genetics Identical twins-show rate of leukemia Fraternal twins-show rate Translocation of genes-cause unknown Environment Ionizing radiation-sun, nuclear exposure o S&S Pallor Malaise to fatigue Fever Bleeding-petechiae, ecchymosis, gingival bleeding, epitaxis (nose bleeds) Weight loss Lymphadenopathy-nodes, spleen, liver (abnormal) CNS, HA (headaches), N&V, seizures, coma o Dx HgB, Hct, WBCs PT (prothrombin time) and PTT (partial thromboplastin time)-measures clotting speed uric acid (hyperuricemia)-due to cell breakdown and chemo Bone biopsy-from hip, breast bone-cells are absent-bone is like a honey comb Only way to truly dx
Hematologic Hemoglobin o
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