Leukemia

Definition

Leukemia is a malignant proliferation of white blood cell precursors in the bone marrow, crowding out normal hematopoietic cells and leading to pancytopenia.

Types

• Acute Lymphoblastic Leukemia (ALL): Most common childhood cancer; good prognosis.
• Acute Myeloid Leukemia (AML): More common in adults.
• Chronic Lymphocytic Leukemia (CLL): Elderly; often slow.
• Chronic Myeloid Leukemia (CML): Philadelphia chromosome; imatinib.

Signs and Symptoms

Fatigue, pallor (anemia), infection/fever (leukopenia), bruising/bleeding (thrombocytopenia), bone pain, lymphadenopathy, hepatosplenomegaly.

Nursing Interventions

• Neutropenic precautions
• Bleeding precautions
• Monitor CBC, platelets, absolute neutrophil count
• Chemotherapy/radiation/stem cell transplant management
• Oral care for mucositis
• Psychosocial support

NCLEX Relevance

Neutropenic + bleeding precautions. Fever in neutropenia = emergency.