Question

A.J. is a 63-year-old white woman who is brought to the emergency department by her husband. She has become progressively weaker and was admitted for further evaluation.

Subjective data: complains of progressive weakness over the last couple of weeks, has had a recent sinus infection that resolved after two courses of antibiotics, complains of shortness of breath, has noticed a lot of bruising lately

Objective data: Physical exam: Has scattered petechiae on both ankles and two ecchymoses on her arms and one on her left lower leg, her skin is very pale, B/P 100/70 (lying), temperature 96.8 F, respiratory rate 26/min.

Labs: Hct 18.2%, Hgb 5.9 g/dL, WBC 2600/uL, Platelet count 72,000/uL, peripheral blood smear indicates that 80% of the WBCs are blasts, PT 18 sec., aPTT 37 sec, LDH 560 units/L

Bone Marrow biopsy: Multiple myeloblasts (>50%)

Interprofessional care: Consultation with a hematologist-oncologist, two units of packed red blood cells, diagnosis –acute myelogenous leukemia

What components of the laboratory test results and bone marrow biopsy suggest acute leukemia?

How is acute myelogenous leukemia treated?

What is A.J.’s prognosis?

What are the life-threatening problems that can occur as a result of this disease and treatment? How can you anticipate and assess for these problems?

Answer 1

What components of the laboratory test results and bone marrow biopsy suggest acute leukemia?

The hematocrit, Hemoglobin, and platelet check are on the whole to a great degree low, showing ablood issue. The high white blood check alongside the different myeloblasts affirm undifferentiated and juvenile cells, which is characteristic of intense leukemia. As J.J. is a grown-up, intense myeloid leukemia (AML) would be suspected.

How is acute myelogenous leukemia treated?

All in all, treatment falls into two stages:

Abatement enlistment treatment. The inspiration after the primary epoch of management is to murder the leukemia cells in your blood and bone marrow. Notwithstanding, abatement acceptance for the maximum share doesn't wipe out the superior share of the leukemia cells, so you require promote treatment to keep the illness from returning.

Solidification treatment. Likewise called post-reduction treatment, support treatment or increase, this period of treatment is gone for annihilating the rest of the leukemia cells. It's viewed as essential to diminishing the danger of backslide.

What is A.J.’s prognosis?

In spitefulness of the detail that AML is an honest illness, it is remediable besides regularly reparable through chemo therapy with otherwise deprived of a bone marrow/undifferentiated organism transplant. Remember that measurements on the survival rates for individuals with AML are a gauge.

What are the life-threatening problems that can occur as a result of this disease and treatment?

Intense leukemia is ordered by the kind of white platelets influenced. The two primary sorts of white platelets are:

-Lymphocytes – for the maximum share used to battle viral diseases

-myeloid cells – which play out various distinctive capacities, for example, battling bacterial diseases, shielding the body against parasites and keeping the spread of tissue harm.

How can you anticipate and assess for these problems?

AML happens when specific cells called foundational microorganisms, which are found within the bone-marrow a light material inside the bones, create excessively numerous youthful white platelets. These youthful cells are known as impact cells.

Impact cells don't have the disease battling properties of sound white platelets, and creating an excessive number of can prompt a cut in the quantity of red platelets (which convey oxygen within the blood) and platelets (cells that assistance the blood to mass).

It's not clear precisely why this happens and, by and large, there's no identifiable reason. In any case, various components that can expand your danger of creating AML have been recognized. These include:

-past chemotherapy or radiotherapy

-presentation to large amounts of radiation (counting past radiotherapy treatment)

-Presentation to benzene – a concoction utilized as a part of assembling that is additionally found in tobacco smoke

-having a fundamental blood issue or hereditary issue, for example, down’s disorder.