Acute Myeloid Leukemia

Overview of Leukemia

  • Definition of Leukemia: A type of cancer that affects blood cells, particularly leukocytes (white blood cells).
  • Leukocytosis: Refers to an increase in leukocytes in circulation, a common feature in leukemia.

Pathophysiology of Leukemia

  • Unregulated Proliferation: One of the common features of leukemia is an unregulated proliferation (rapid and uncontrolled increase) of leukocytes in the bone marrow.
  • Consequences: The overproduction of leukocytes leads to diminished production capacity and space for normal blood cells, which increases the risk of developing leukemia.

Classification of Leukemia

Types of Leukemia

  • Based on Stem Cell Line:
    • Lymphoid Cells: Produce lymphocytes.
    • Myeloid Cells: Produce non-lymphoid blood cells.

Acute vs. Chronic Leukemia

  • Acute Leukemia:

    • Symptoms generally present abruptly.
    • Composed mainly of undifferentiated cells or blast cells.
    • Rapid progression, with possible mortality occurring in weeks to months without treatment.

  • Chronic Leukemia:

    • Symptoms evolve gradually over months to years.
    • Majority of leukocytes are mature cells.
    • Slow progression.

Types of Acute Leukemia

Acute Myeloid Leukemia (AML)

  • Overview: The most common form of leukemia with the highest mortality rates. Can affect any age, with a median diagnosis age of 68 years.
  • Clinical Manifestations:
    • Anemia
    • Thrombocytopenia
    • Neutropenia
    • Impairment of neutrophils, basophils, and eosinophils
    • Pain from splenomegaly (enlarged spleen) or hepatomegaly (enlarged liver).
    • Hyperplasia of gums and bone marrow pain due to expansion.
  • Risk Factors:
    • Increased age.
    • Higher incidence in males than females.
    • Chemical exposure (e.g., pesticides).
    • History of chemotherapy treatments.
    • Tobacco smoke.
    • Genetic disorders (e.g., Down syndrome) and other blood disorders.
  • Complications:
    • Bleeding
    • Increased risk of infections
  • Treatment:
    • Chemotherapy.
    • Allogeneic stem cell transplant.

Chronic Myeloid Leukemia (CML)

  • Overview: Similar risk factors to AML.
  • Clinical Manifestations:
    • Typically few symptoms during the chronic stage.
    • Fatigue
    • Anemia
    • Dyspnea (shortness of breath)
    • Weight loss.
  • Treatment:
    • Iodine kinase inhibitors that block growth signals of the cells.

Types of Lymphoid Leukemia

Acute Lymphoblastic Leukemia (ALL)

  • Details not provided in the transcript but generally known to affect lymphoid cells markedly.

Chronic Lymphocytic Leukemia (CLL)

  • Overview: Common in older adults, average age of diagnosis is approximately 71 years old.
  • Clinical Manifestations:
    • Asymptomatic or diagnosed incidentally during lab tests or physical exams.
    • Possible findings include splenomegaly or lymphadenopathy (enlarged lymph nodes).
  • Treatment:
    • Chemotherapy.

Nursing Interventions for All Types of Leukemia

  • Managing leukocytosis.
  • Improving nutritional intake.
  • Increasing pain and discomfort management.
  • Decreasing fatigue and activity intolerance.
  • Maintaining fluid and electrolyte balance.
  • Improving self-care practices.
  • Managing anxiety and grief.
  • Encouraging spiritual well-being.
  • Promoting effective home care for patients.