SLOs for Acute Lymphblastic/cytic Leukemia and Lung Cancer

define and describe differences between solid tumors (lung) and liquid tumors (all)

solid: lump/mass of abnormal cells that come from any tissue/organ (besides blood/bone marrow)

• begin and grow in a specific location

• might be surgically removable

• not all of them are malignant

liquid: already systematic, infiltrates other organs via bloodstream/lymphatic system

• can have sanctuary sites that requires targeted therapy

risk factors, clinical presentation, diagnostic labs for lung cancer

risk factors

• male, smoking hx, copd, pollution area, middle aged

clinical s/s

• persistent cough

• chest pain

• shortness of breath, wheezing

• rust-colored phlegm

• feeling tired/fatigue (from anemia)

• hoarseness (smoker’s voice)

• frequent lung infections

diagnostic labs

• ct scan, mri, ultrasound, chest x-ray

risk factors, clinical presentation, diagnostic labs for acute lymphblastic leukemia

risk factors

• genetic

clinical s/s

• bruising/bleeding

• pallor (from anemia)

• bone/joint pain

• brain: headaches, seizures, balance impaired, vision impaired

• lymph nodes → chest pain, breathing problems

• loss of appetite, weight loss

• petechiae

• painless lumps (lymphadenopathy)

diagnostic labs

• cbc with differential, peripheral blood smear, bone marrow aspiration and biopsy

differences between pediatric and adult forms of acute lymphblastic/cystic leukemia

lymphblastic: immature lymphoid precursors

• rapid onset, progression

• high proportion of lymphblasts

• fever, fatigue, bleeding, bone pain

• tx: intensive chemo and/or stem cell transplant

lymphcystic: mature lymphocytes (B or T cells)

• slow growing

• more proportion of mature lymphocytes

• asymptomatic for prolonged time

• tx: targeted therapy, otherwise “watch and wait”

treatment regimens for lung cancer and acute lymphblastic leukemia

lung cancer

• radiation: kill/damage DNA of cancer cells (cause skin irritation, fatigue, hair loss, organ-specific)

• chemotherapy: destroys cancer cells, shrinks/slows tumor growth, palliation, does not distinct cells from cancer vs. normal (affects bone marrow, hair follicles, GI lining, reproductive cells → mucositis, brain fog, anemia, neutropenia)

acute lymphblastic leukemia

• radiation

• chemotherapy

common priority interventions and outcomes for patients with lung cancer and acute lymphblastic leukemia

• any concerns r/t tumor/site of metastases → causing any damage to other body parts, any bone marrow suppression/dysfunction/failure

• any complications from treatment (chemo/radiation/immunotherapy/bone marrow transplant/surgical)

• infection risk? → neutropenia, infections, decreased immunity

• blood clotting and bleeding disorders

• current nutritional deficits or weight loss

• pain interventions r/t tumor, side effects of therapies

• pallative care → long-term decline to end-of-life

• liquid tumor → hyperkeukocytosis/leukostatsis (elevated WBCs impacting blood flow), tumor lysis syndrome (lysis of cancer cells leads to increased K+, PO4-, uric acid)

• solid tumor → late diagnosis that occurs in later stages, paraneoplastic syndrome (disordered immune responses)