Question

Discussion Topic# 1: What is a “shift to the left” in a CBC? Discussion Topic# 2: A father brings in his 3-year-old son, James, who was initially running a fever. He was given Tylenol, and the fever went away for 2 days. Now, however, the fever is back, and he has noted dark spots on his body and a lump in his armpit. He has been lethargic and has not wanted to eat for the last 24 hours. The physician suspects acute lymphocytic leukemia and has ordered blood chemistry studies, immunophenotyping, and bone marrow aspiration and biopsy. The father is upset and wants to know what is leukemia and how did his son catch it? How would the nurse address this question?

Answer 1

1. Shift to Left is an increase in the number of immature cell types among the blood cells in a sample of blood. Mostly it refers to the white blood cell lineage, particularly neutrophil-precursor band cells,thus signifying bandemia. Less commonly, left shift may also refer to a similar phenomenon in the red blood cell lineage in severe anemia, when increased reticulocytes and immature erythrocyte-precursor cells appear in the peripheral circulation.

2. Leukemia is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

"Acute" in acute Lymphocytic Leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones.

It is the most common type of cancer in children, and with treatments it has good chance for a cure.

The leukemia is mostly diagnosed by-

• Bone pain
• Fever
• Frequent infections
• Lumps caused by swollen lymph nodes in and around the neck, underarm, abdomen or groin
• Pale skin
• Weight Loss
• Weakness, fatigue or a general decrease in energy

Leukemia occurs when a bone marrow cell develops errors in Cell Formation. A normal cell would stop growing and Eventually die whereas a cancer cell is abnormal and Continues to grow. This occurs if child is ever-

• Exposed to radiation. Such as survivors of a nuclear reactor accident
• Has Some Genetic disorders. Certain genetic disorders, such as Down syndrome.
• Having a brother or sister with ALL. People who have a sibling, including a twin, with acute lymphocytic leukemia.
• Previous cancer treatment. Children who've had certain types of chemotherapy and radiation therapy for other kinds of cancer may have an increased risk of developing acute lymphocytic leukemia.