Page 918 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 31

Oncological Problems

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Priority Concepts
Cellular Regulation; Safety

I. Leukemia
A. Description
1. Leukemia is a malignant increase in the number of
leukocytes, usually at an immature stage, in the bone
marrow.

2. In leukemia, proliferating immature white

blood cells (WBCs) depress the bone marrow, causing
anemia from decreased erythrocytes, infection from
neutropenia, and bleeding from decreased platelet
production (thrombocytopenia).
3. The cause is unknown; it seems to involve genetic
damage of cells, leading to the transformation of cells
from a normal state to a malignant state.
4. Risk factors include genetic, viral, immunological, and
environmental factors and exposure to radiation,
chemicals, and medications.
5. Acute lymphocytic leukemia is the most frequent type
of cancer in children.
6. Leukemia is more common in boys than girls after 1
year of age.
7. Prognosis depends on various factors such as age at
diagnosis, initial WBC count, type of cell involved,
and sex of the child.
8. Treatment involves chemotherapy and possibly
radiation and hematopoietic stem cell transplantation.
9. The phases of chemotherapy include induction, which
achieves a complete remission or disappearance of
leukemic cells; intensification or consolidation
therapy, which decreases the tumor burden further;
central nervous system prophylactic therapy, which
prevents leukemic cells from invading the central
nervous system; and maintenance, which serves to

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