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# Mometrix ## Infiltration of the CNS - Resulting in increased intracranial pressure, ventricular dilation and meningeal irritation with headaches, vomiting, papilledema, nuchal rigidity, and coma progressing to death. ## Hypermetabolism - That deprives cells of nutrients, resulting in anorexia, we...

# Mometrix ## Infiltration of the CNS - Resulting in increased intracranial pressure, ventricular dilation and meningeal irritation with headaches, vomiting, papilledema, nuchal rigidity, and coma progressing to death. ## Hypermetabolism - That deprives cells of nutrients, resulting in anorexia, weight loss, muscle atrophy, and fatigue. ## Leukemia vs. Leukocytosis - Leukemia occurs when one type of WBC proliferates with immature cells, with the defect occurring in the hematopoietic stem cell, either lymphoid (lympho-) or myeloid (myelo-). - Usually leukemias classified as blast cell or stem cell refers to lymphoid defects. - With acute leukemia, WBC count remains low because the cells are halted at the blast stage, and the disease progresses rapidly. - Chronic leukemia progresses more slowly, and most cells are mature. ## AML & ALL - Acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) are the two most common types of leukemias that affect children. - AML is also referred to as granulocytic, myelocytic, monocytic, myelogenous, monoblastic, and monomyeloblastic leukemia. - It is caused by a defect in the stem cells that differentiate into all myeloid cells. - AML affects all ages, occurring in children and adults, and often has a genetic component. - Survival rates with adequate treatment are about 50%. - ALL is also referred to as lymphatic, lymphocytic, lymphoblastic or lymphoblastoid leukemia and is caused by a defect in the stem cells that differentiate into lymphocytes. - This is the most common type of childhood leukemia, peaking between ages 2-5. - The cause is not known. - There are a number of different types of ALL, and treatment and survival relate to the type. - Overall survival rates with adequate treatment are about 80%. ## Some rare forms - Of leukemia are named for the cells involved, such as basophilic leukemia. # Three Stages of Leukemia Treatment - Leukemia treatment depends upon the protocol established for each type of leukemia. - Combined drugs are usually more effective than single. - Chemotherapy, usually includes 3 stages: ## Induction - The purpose is to induce remission to the point that the bone marrow is clear of disease, and blood counts are normal. - Chemotherapy is usually given for about 4-6 weeks, followed by transplantation or the next stage of chemotherapy. - The chemotherapy is potent and suppresses blood elements, leaving the body at risk for serious infections and hemorrhage, so supportive care is critical. ## Consolidation - The goal is to kill any cells that may have escaped the induction stage. - This stage lasts 4-8 months. - Intrathecal chemotherapy may be administered concurrently as a prophylaxis to prevent CNS involvement. ## Maintenance - Treatment may continue for another 2-3 years, but with less intense chemotherapy to maintain the child in remission. - Weekly blood counts monitor progress and side effects. # Relapse Treatments - Sometimes, after the 3 stages of chemotherapy for leukemia are completed, the child will relapse and leukemic cells return. - In that case, re-induction is carried out, usually using a different arsenal of drugs. - Many drugs in use now, especially for relapses, are those in clinical trials. Clinical trials are.