PNC /BSN 2020

1. Prepared by : Katherine Casacop
ACUTE LYMPHOCYTIC
LEUKEMIA

2.  Acute lymphocytic leukemia (ALL), also known as acute
lymphoblastic leukemia, refers to an abnormal growth of
lymphocyte precursors or lymphoblasts.
Acute leukemia is a malignant proliferation of white
blood cell precursors in bone marrow or lymph tissue,
and their accumulation in peripheral blood, bone
marrow, and body tissues.
About 20% of leukemias are acute.

3.  Accumulation. Due to the
precipitating factors, immature, non-
functioning WBCs appear to
accumulate first in the tissue where
they originate (lymphocytes in lymph
tissue, granulocytes in bone marrow).
 Infiltration. These immature WBCs
then spill into the bloodstream and
from there infiltrate other tissues.
 Malfunction. Eventually, this
infiltration results in organ
malfunction because of encroachment
and hemorrhage
PATHOPHYSIOLOGY

4. Congenital disorders.
Familial tendency.
Viruses.
CAUSES

5. High fever
Bruising
Dyspnea
Anemia
Tachycardia
CLINICAL MANIFESTATIONS

6.  Health history. The health history may reveal a
range of subtle symptoms reported by the patient
before the problem is detectable on physical
examination.
 Physical examination. A thorough, systematic
assessment incorporating all body systems is
essential.
 Laboratory results. The nurse also must closely
monitor the results of laboratory studies and
culture results need to be reported immediately.
NURSING ASSESSMENT

7.  Infection. Immature WBCs are
not fit to defend the body
against pathogens, so
infection is always a possible
complication to watch out for.
 Organ malfunction.
Encroachment or hemorrhage
occurs when immature WBCs
spill into the bloodstream and
other tissues and eventually
lead to organ or tissue
malfunction.
COMPLICATIONS

8.  Bone marrow aspiration.
 Bone marrow biopsy.
 Blood counts.
 Differential leukocyte
count.
 Lumbar puncture.
 Uric acid levels.
ASSESSMENT AND DIAGNOSTIC
FINDINGS

9.  Systemic chemotherapy. Systemic
chemotherapy aims to eradicate
leukemic cells and induce remission
(less than 5% of blast cells in the
marrow and peripheral blood are
normal).
 Radiation therapy. Radiation therapy is
given for testicular infiltrations.
 Platelet transfusion is performed to
prevent bleeding and RBC transfusion
to prevent anemia
MEDICAL MANAGEMENT

10. Vincristine
Prednisone
Cytarabine
L-asparaginase
Daunorubicin
Antibiotic, antifungal, and
antivirals
PHARMACOLOGIC THERAPY

11.  Bone marrow transplant. Bone
marrow transplant is a choice
that can be considered for a
patient with ALL.
 Stem cell transplant. Stem cell
transplant in ALL is one of the
latest development in the
treatment of acute leukemias
SURGICAL MANAGEMENT

12. The care plan for the
leukemic patient should
emphasize comfort, minimize
the adverse effects of
chemotherapy, promote
preservation of veins,
manage complications, and
provide teaching and
psychological support.
NURSING MANAGEMENT

13. •

15. .