Pathophysiology

Predisposing Factors:

AgeGenderRace

Family HIstory

ETIOLOGY:Unknown

Precipitating Factors:exposure to radiation

and certain chemicals having a sibling with

leukemiaHTLV-1 virusgenetic abnormalities chromosomal

translocationsSomatic mutations in

the DNA

Activate oncogene/ deactivate tumor-supppresor gene

Malignant transformation of lymphoid stem cells

Uncontrolled proliferation of lymphoblast in the bone

marrow

s/sx:bone painjoint pain

Treatment:Analgesic

Lymphoblast replace the normal marrow elements

Diagnostic Test:

BM aspirationBM biopsy

Treatment:Remission

Induction TherapyConsolidation and

Maintenance Therapy

BM Transplantation CNS prophylaxis

Decreased production of normal blood cells

Decreased production of normal blood cells

Leukopenia

(↓4.36 x 10 9/L)

Diagnostic Test:CBC

s/sx:presence of

petechiaebruise & bleed

easilyanemiafatiguedizzinesspalpitationsdyspnea

Treatment:Blood

transfusionEpoetin and

hemapoetic stimulantsSpillage of lymphoblast

into the bloodstream

Organ infiltration

Infections/sx:fever, chills

seizure

If not treatedIf treated:Antibiotic

IgLeukapheresis

Septicemia

DeathPrevention of complications

Kidneys

Renal failure

s/sx:Little/ no UO↑RRFlank painRestlessn/v legs and

feet swellinguremiaazotemia

CNSDiagnostic Test:MRI

Treatment:Intrathecal

chemotherapy

leukocyte cells impairs the

circulation of CSF

leukocyte cells compresses

spinal/ cranial nerves

Diagnostic Test:

Spinal Tap

s/sx:h/a, weakness, blurred

vision, balance difficulty, vomiting, lethargy

s/sx:↑ CSF

leukocytes

s/sx:cranial nerve palsies

confusional statesoptic neuropathy

cerebellar dysfunctionpapilledemaProgress to coma

Liver / Spleen

Extra cells cause the

liver/spleen to rupture

Diagnostic Test:

Ultrasonography

s/sx:hepatomegal

ysplenomegalyelevated ALT

(81 u/L)bleeding

Hypovolemic shock

s/sx:hypotensiontachypnea

tachychardia

Overgrown thymus

Compress the Superior Vena Cava

SVC syndrome

s/sx:swelling of

head, neck and arms

obstruction of blood flow

s/sx:shortness of

breathcough

suffocation

Lymph nodes

Mediastinal lymphadenopathy

Bronchial/tracheal obstruction

Esophageal compression

Erosion of node into a bronchus/ trachea

Severe hypoxia

Physical Exam

Diagnostic test:

Lymph node biopsy

s/sx:lymphadenopathy

s/sx:cough, wheezes, respiratory tract

obstruction

Treatment:O2

administrationBronchodilators

s/sx:dysphagia

s/sx:hemoptysis

DEATH