N401= Blood Cancers, Brain Tumor, and SCI

Lymphoma

Is a type of cancer that begins in the lymphatic system, which is an important part of the body’s immune system. It develops when certain white blood cells, called lymphocytes, grow abnormally and multiply uncontrollably.

Can affect lymph nodes and other organs, including the spleen, bone marrow, thymus, stomach, and skin

Occurs when B cells and T cells become cancerous.

How does the lymphatic system help?

Fight infection

Filter harmful substances from the body

Transport lymph fluid

Produce and store immune cells.

Lymphocytes are the main cells involved in lymphoma. There are two major types:

B Lymphocytes (B cells)= produce antibodies to fight infections

T Lymphocytes (T cells)= Helps coordinate immune responses and destroy infected or abnormal cells

Hodgkin Lymphoma (HL)

Characterized by the presence of abnormal Reed-Sternberg cells in classical Hodgkin lymphoma.

Often begins in lymph nodes in the neck, chest, or armpits.

Frequently spreads in a predictable pattern.

Generally has high treatment success rates, even in advanced stages

Non-Hodgkin Lymphoma (NHL)

A large group of lymphomas involving B cells, T cells, or rarely NK cells.

More common than Hodgkin lymphoma.

Can be slow-growing (indolent) or fast-growing (aggressive).

Includes diffuse large B-cell lymphoma, follicular lymphoma, and Burkitt lymphoma

Common symptoms for Lymphoma

Important: Fever, night sweats, and unexplained weight loss are sometimes called B symptoms. They are particularly important when staging lymphoma.

Not everyone with lymphoma experiences all these symptoms:

Painless swollen lymph nodes Neck, armpit, or groin

Fever Unexplained or recurrent fever

Night sweats Severe sweating during sleep

Weight loss

Unintentional loss of 10% or more of body weight over 6 months

Fatigue Persistent tiredness

Itching Generalized itching without an obvious cause

Loss of appetite Reduced desire to eat

Causes and Risk Factors of Lymphoma

The exact cause of lymphoma is often unknown.

Factors associated with increased risk include:

Weakened immune system. Certain autoimmune diseases. Some viral infections, such as Epstein-Barr virus (EBV).

Certain bacterial infections, such as Helicobacter pylori.

Family history of lymphoma. Increasing age for many lymphoma subtypes. Certain immunosuppressive medications.

Having a risk factor does not mean someone will develop lymphoma.

How Lymphoma is Diagnosed

1. Lymph node biopsy. The most important diagnostic test. A lymph node or affected tissue is removed and examined under a microscope.

2. Blood tests. CBC, kidney and liver function, LDH, and other tests to evaluate overall health and disease effects.

3. Imaging studies= PET-CT and CT scans help determine where lymphoma is located and how far it has spread.

4. Bone marrow examination= Sometimes performed to determine whether lymphoma has affected the bone marrow.

Treatment options of Lymphoma

Depends on the lymphoma type, stage, aggressiveness, symptoms, and patient's overall health.

Chemotherapy=Uses drugs to destroy cancer cells

Immunotherapy=Helps the immune system recognize and attack cancer cells

Radiation therapy= Uses high-energy radiation to destroy cancer cells

Targeted therapy= Targets specific proteins or pathways in cancer cells

Stem cell transplant= Replaces damaged blood-forming cells after intensive treatment

CAR T-cell therapy= Modifies a patient's T cells to recognize and attack cancer cells

Active surveillance= Monitors certain slow-growing lymphomas without immediate treatment.

Patient Teaching for Lymphoma

Patient education is an important part of care. The goal is to help patients understand their disease, manage treatment side effects, prevent infections, recognize complications, and maintain the best possible quality of life

Infection prevention= Very important, Patients with lymphoma may have weakened immune systems due to the disease or treatment, especially chemotherapy.

Nutrition and hydration

Medication and chemotherapy safety

Physical activity and rest

Emotional and psychological support

Recognizing emergency warning signs for Lymphoma

Seek immediate medical attention

Teach patients to recognize the following symptoms: Fever ≥100.4°F (38°C) during

chemotherapy=Possible serious infection

Difficulty breathing Possible respiratory or cardiac complication

Chest pain Possible serious heart or lung problem

Uncontrolled bleeding Possible low platelet count

Confusion or severe headache Possible neurological complication

Severe vomiting or diarrhea Risk of dehydration

Sudden severe weakness Possible serious treatment complication

Painful, swollen arm or leg Possible blood clot

Neutropenic Precautions (Nursing Patient Education)

Important for patients receiving chemotherapy

Neutropenic precautions are safety measures used to protect patients who have a low neutrophil count and are at increased risk of developing serious infections.

Neutropenia commonly occurs in patients with lymphoma because of the cancer itself or treatments such as chemotherapy.

1. What is neutropenia? Neutropenia is a decrease in the number of neutrophils, a type

of white blood cell that helps the body fight bacterial and fungal infections.

The Absolute Neutrophil Count (ANC) measures the number of neutrophils in the blood.

High riskAn ANC below 500 cells/mm³ significantly increases the risk of

serious infection.

Food Safety and Nutrition for Neutropenic patients

Foods to avoid: Raw or undercooked meat. Raw or undercooked eggs. Raw seafood and sushi. Unpasteurized milk, cheese, or juice. Unwashed fruits and vegetables.

Safe food practices: Cook meat, fish, and eggs thoroughly. Wash fruits and vegetables under running water. Refrigerate perishable foods promptly. Avoid expired foods. Keep raw and cooked foods separate. Wash hands and kitchen surfaces before food preparation

Nursing interventions for neutropenic patients

Monitor temperature regularly=Detect infection early

Monitor CBC and ANC= Identify severity of neutropenia

Perform proper hand hygiene= Prevent transmission of microorganisms

Assess skin and oral mucosa= Identify early signs of infection

Use aseptic technique= Reduce exposure to pathogens

Limit exposure to sick visitors= Prevent infection

Administer prescribed medications= Prevent or treat infections

Educate patient and family= Promote safety at home

Bleeding Precautions for a Patient with Lymphoma

are safety measures used to prevent bleeding in patients with lymphoma who have low platelet counts (thrombocytopenia).

Patients with lymphoma may develop thrombocytopenia because:

- Lymphoma may affect the bone marrow, reducing platelet production.

-Chemotherapy can suppress bone marrow function.

-Radiation therapy involving bone marrow may reduce blood cell production.

-Certain medications may interfere with platelet function

What to teach patients who are neutropenic

Use a soft-bristled toothbrush.

Use an electric razor instead of a blade razor.

Avoid contact sports and activities with a high risk of falling.

Avoid aspirin unless specifically prescribed.

Eat a balanced diet.

Teach patients to watch for neutropenic:

Petechiae =Tiny red or purple spots on the skin

Ecchymosis= Unusual bruising

Bleeding gums= Bleeding while brushing teeth

Epistaxis= Nosebleeds

Hematuria= Blood in urine

Melena= Black, tarry stools

Hematochezia= Blood in stool

Heavy menstruation= Excessive menstrual bleeding

The 5 B's of bleeding precautions

Brush gently with a soft toothbrush.

Blade razor avoidance—use an electric razor.

Be careful to prevent falls and injuries.

Beware of aspirin and NSAIDs unless approved.

Blood in urine, stool, or vomit must be reported immediately.

Key points to remember for Lymphoma

is a cancer of lymphocytes.

The two main categories are Hodgkin and non-Hodgkin lymphoma.

Painless swollen lymph nodes are a common presentation.

Night sweats, fever, and unexplained weight loss are important warning symptoms.

A tissue biopsy is essential for diagnosis.

PET-CT and other imaging help determine the stage.

Treatment depends on the specific subtype, not just the stage.

Many lymphomas are highly treatable, and some are curable.

Leukemia

is a type of cancer that affects the blood-forming tissues, especially the bone marrow. It causes the abnormal production and uncontrolled growth of white blood cells.

These abnormal cells interfere with the production of normal blood cells, including:

-Red blood cells (RBCs), which carry oxygen.

- White blood cells (WBCs), which fight infections.

- Platelets, which help blood clot and prevent bleeding.

- Leukemia can affect people of all ages, including children and adults

The bone marrow produces what? And how are they effected in Leukemia?

healthy blood cells. abnormal white blood cells multiply uncontrollably and crowd out normal blood cells.

-This can lead to:

- Anemia: Too few red blood cells.

- Infection: Too few functional white blood cells.

- Bleeding: Too few platelets.