Oncology Nursing: Leukemias, Lymphomas, Chemotherapy, and Radiation Therapy

Vocabulary practice flashcards covering acute leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma, chemotherapy administration, extravasation protocols, and external beam radiation therapy.

Acute Lymphocytic Leukemia (ALL)

A form of leukemia characterized by the abnormal proliferation of lymphocyte precursors (lymphoblasts), with approximately 80% involving B-cell lineages and 20% involving T-cell lineages.

Acute Myeloid Leukemia (AML)

A malignancy characterized by the rapid accumulation of myeloid precursors (myeloblasts) in the bone marrow and peripheral blood, occurring more commonly than ALL.

What happens to blood cells in leukemia

Immature, nonfunctioning WBCs (blasts) proliferate and enter the bloodstream, overwhelming normal red blood cells and platelets and leading to a marked decrease in RBC production.

Bone Marrow Aspiration and Biopsy

The definitive diagnostic procedure confirming acute leukemia by demonstrating a proliferation of immature WBCs; typically performed at the posterior superior iliac spine if aspirate is dry.

Flow Cytometry (Immunophenotyping)

A diagnostic laboratory test used to determine the specific immunophenotypic cell type of acute leukemia and distinguish AML from ALL.

Non-Hodgkin Lymphoma (NHL)

A heterogeneous group of malignant lymphoid neoplasms characterized by the progressive clonal expansion of B-cells, T-cells, or natural killer cells that lack Reed-Sternberg cells.

Nodular Infiltration Pattern (NHL)

A structural pattern of lymphoid tissue infiltration in non-Hodgkin lymphoma that carries a better prognosis than the diffuse infiltration form.

Lugano Classification Staging System

The standard four-stage staging system utilized to determine disease progression, treatment, and prognosis in patients with non-Hodgkin lymphoma based on nodal and extralymphatic involvement.

Hodgkin Lymphoma

A neoplastic disorder of lymphoid tissue characterized by painless, progressive enlargement of lymph nodes and spleen, distinguished by the histologic presence of Reed-Sternberg cells.

Reed-Sternberg Cells

Giant, abnormal multinucleated histiocytic/lymphocytic cells with large, distinct nucleoli that serve as the pathognomonic diagnostic hallmark of Hodgkin lymphoma.

Nodular Sclerosis

The most common subtype of classic Hodgkin lymphoma, accounting for 60% to 80% of classic cases, and most frequently diagnosed in young adults.

Mixed Cellularity Subtype

A subtype of classic Hodgkin lymphoma that is more commonly diagnosed in late adulthood compared to the nodular sclerosis subtype.

Procarbazine Hydrochloride Dietary Precautions

A dietary requirement during procarbazine therapy mandating the avoidance of vanilla, cheese, and wine to prevent adverse dietary-drug interactions.

Adjuvant Chemotherapy

Chemotherapy administered after primary surgical resection or radiation therapy to eradicate undetectable micrometastases and prevent cancer recurrence.

Induction (Neoadjuvant) Chemotherapy

Chemotherapy administered prior to surgery or radiation therapy to shrink the tumor mass and improve surgical resectability and survival rates.

Folinic Acid (Leucovorin) Rescue

An antidote given following high-dose toxic methotrexate therapy to rescue normal tissue and vital organs from permanent destruction.

Intraperitoneal Chemotherapy

Direct administration of chemotherapeutic agents into the peritoneal cavity via an implanted port and catheter to achieve high local drug concentrations for advanced ovarian cancer and peritoneal carcinomatosis.

Vesicant

A classification of chemotherapeutic drugs (such as DOXOrubicin, vinCRIStine sulfate, and CISplatin at doses $>20\,\text{mL}$ of $0.5\,\text{mg/mL}$) that cause severe tissue damage, ulceration, and necrosis if extravasated.

Extravasation

The unintentional infiltration of a vesicant drug into perivascular and subcutaneous tissue due to a punctured vein or leakage around a venipuncture site.

Emergency Extravasation Protocol

Immediate intervention requiring stopping the infusion, disconnecting the IV tubing without removing the access device/needle, attempting to aspirate residual drug using a $3\,\text{mL}$ syringe, and notifying the practitioner.

Vein Patency Testing in Chemotherapy

A safety requirement specifying that vein patency must never be tested using a chemotherapeutic agent; patency must be confirmed with preservative-free normal saline or $D_5W$.

Chemotherapy PPE Guidelines

Hazardous drug safety protocol requiring two pairs of powder-free chemotherapy gloves (changed every 30 minutes), a polyethylene-coated nonlinting gown, eye protection, and respirators as indicated.

Chemotherapy-Induced Myelosuppression Cutoffs

Clinical thresholds requiring stopping the drug if WBC drops suddenly or is $<2{,}000/\text{mm}^3$, initiating neutropenic precautions if absolute granulocytes are $<1{,}000/\text{mm}^3$, and reporting platelets $<100{,}000/\text{mm}^3$.

Stomatitis Oral Rinse Protocol

Mouth care instruction directing the patient to rinse with $1\,\text{tsp}\ (5\,\text{mL})$ of salt dissolved in $8\,\text{oz}\ (237\,\text{mL})$ of warm water, avoiding lemon-glycerin swabs and commercial mouthwashes.

External Beam Radiation Therapy

The most common form of radiotherapy that delivers high levels of external ionizing radiation (typically photon beams produced by linear accelerators or cobalt/cesium gamma units) to impair DNA/RNA synthesis or decrease mitosis.

Curative Radiation

Radiation therapy delivered with the goal of completely destroying the cancer without expectation of recurrence.

Palliative Radiation

Radiation therapy aimed at symptom relief (such as alleviating bone pain, seizures, bleeding, and headaches caused by cancer) rather than tumor cure.

Fractionation and Rest Breaks in Radiotherapy

A treatment schedule delivering radiation daily for 3 to 5 days a week over 5 to 8 weeks, utilizing weekends without treatment to allow normal cells time to recover.

Radiation Skin Protection Teaching

Patient education directing patients to avoid applying unprescribed lotions, deodorants, or powders to the treated skin, use SPF 30 or higher, and avoid direct sun exposure to the irradiated site for 1 year.