Bleeding Disorders

1. PREPARED BY
DR.SHALI B.S
PROFESSOR
MAMATA COLLEGE OF NURSING.KHAMMAM

2. LEUKEMIA

4. • Blood is composed of plasma and Blood cells. The
Blood cells mainly are Red blood cells [R.B.C]
white Blood cells [W.B.C]. W.B.C mainly has the
function to fight against infections.
• There are many blood disorders. Common one is
the anemia and the second common disorder is
Leukemia [Blood Cancer] which is characterized
by abnormal production of mature or immature
forms of any of the white blood cells.

6. • Leukemia is a neoplastic proliferation of the
particular cell type. It originates in the
haematopoietic stem cell, the myeloid or the
lymphoid stem cell.
BRUNNER AND SIDDARTH
• Leukemia is the most common type of childhood
malignancy characterized by persistent and
uncontrolled production of immature and abnormal
white blood cells.

7. ETIOLOGY
• The exact cause of leukemia is not clearly
understood.
• Genetic factor
• Environmental factors

8. RISK FACTORS
Previous cancer treatment
Genetic disorders
Exposure to certain chemicals
Smoking
Family history

9. CLASSIFICATION
Speed of progression
• Acute leukemia (AL)
• Chronic leukemia (CL)
Type of white cells blood cells affected
• Lymphocytic leukemia
• Myelogenous leukemia

11. TYPES OF LEUKEMIA
• Acute Lymphocytic Leukemia(ALL)
• Acute Myelogenous Leukemia(AML)
• Chronic Lymphocytic Leukemia(CLL)
• Chronic Myelogenous Leukemia(CML)
• Other types

14. DIAGNOSTIC EVALUATION
• Peripheral blood examination may show the
following findings;
– Reduced hemoglobin level, RBC count, hematocrit
value and platelet count
– WBC count may be decreased, elevated or normal
• Bone marrow study shows large numbers of
lymphoblasts and lymphocytes with
• hypercelluar condition of bone marrow.
• Chest X- ray helps to diagnose mediastinal mass.
• CSF study determines CNS involvement with
presence of leukemic cells.

15. MEDICAL MANAGEMENT:
• Chemotherapy
• Biological therapy
• Target therapy
• Radiation therapy
• Stem cell transplant

17. CHEMOTHERAPY
 a.Remission induction chemotherapy - It is
administered for 4 to 6 weeks with vincristine,
prednisolone, asparginase and adriamycin.
b.Maintenance therapy or systemic
continuation--- It is given for 2.5 to 3 years
with6Mp(Mercaptopurine)andMTX
(Methotrexate) as per recommended dose.

21. • c. Late intensification or reinforcement therapy-
It is provided with vincristine and prednisolone
every 4 weeks
COMPLICATIONS:
• Bleeding
• Infection
• Organ failure
• DIC
• Seizures
• Intra cranial hemorrhage
• Dysarrythmias
• Tumor lysis syndrome