Pathophysiology

Predisposing Factors: Age Gender Race Family HIstory Precipitating Factors: exposure to radiation and certain chemicals having a sibling with leukemia HT !"# virus genetic abnormalities chromosomal translocations

ETIOLOGY: Unknown

$omatic mutations in the %&A

Activate oncogene' deactivate tumor" supppresor gene

(alignant trans)ormation o) lymphoid stem cells s/sx: bone pain *oint pain

Uncontrolled proli)eration o) lymphoblast in the bone marrow Diagnostic Test: +( aspiration +( biopsy

Treatment: Analgesic

ymphoblast replace the normal marrow elements

Treatment: Remission Induction Therapy ,onsolidation and (aintenance Therapy +( Transplantation CNS prophylaxis

%ecreased production o) normal blood cells

Diagnostic Test: ,+,

eukopenia -./012 x #3 4' 5

%ecreased production o) normal blood cells

s/sx: )ever: chills sei7ure

In)ection

$pillage o) lymphoblast into the bloodstream

s/sx: presence o) petechiae bruise 6 bleed easily anemia )atigue di77iness palpitations dyspnea

Treatment: +lood trans)usion 8poetin and hemapoetic stimulants

9rgan in)iltration If treated: Antibiotic Ig eukapheresis If not treated

$epticemia

;revention o) complications

Death

<idneys s/sx: ittle' no U9 =RR Flank pain Restless n'v legs and )eet swelling uremia azotemia

Diagnostic Test: (RI Treatment: Intrathecal chemotherapy

CNS s/sx: h'a: weakness: blurred vision: balance di))iculty: vomiting: lethargy iver ' $pleen Diagnostic Test: Ultrasonography

Renal )ailure

leukocyte cells impairs the circulation o) ,$F

s/sx: = ,$F leukocytes s/sx: cranial nerve palsies con)usional states optic neuropathy cerebellar dys)unction papilledema

8xtra cells cause the liver'spleen to rupture

Diagnostic Test: $pinal Tap

leukocyte cells compresses spinal' cranial nerves

bleeding Hypovolemic shock

s/sx: hepatomegal y splenomegaly elevated A T -># u' 5 s/sx: hypotension tachypnea tachychardia

;rogress to coma

9vergrown thymus

,ompress the $uperior !ena ,ava

s/sx: shortness o) breath cough su))ocation

;hysical 8xam Diagnostic test: ymph node biopsy

Lymph nodes

(ediastinal lymphadenopathy

s/sx: lymphadenopathy $!, syndrome s/sx: swelling o) head: neck and arms obstruction o) blood )low Treatment: 9? administration +ronchodilators s/sx: cough: whee7es: respiratory tract obstruction

+ronchial'tracheal obstruction 8sophageal compression

s/sx: dysphagia

8rosion o) node into a bronchus' trachea

s/sx: hemoptysis

$evere hypoxia

%8ATH