ACUTE LYMPHOBLASTIC LEUKEMIA ACROSS THE LIFE SPAN 1
Acute Lymphoblastic Leukemia across the Life Span
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Overall review of the disease
Acute lymphoblastic leukemia (ALL) is a malicious alteration of lymphoid progenitor
cells in the bone marrow, blood, and other extramedullary spots in the body. In America, the
second common type of acute leukemia is the ALL with lots of cases diagnosed annually. In
2016 the American Cancer Society diagnosed people, and 6590 was the estimated population
diagnosed with this disease. Acute lymphoblastic leukemia is marked by chromosomal
abnormalities, multiplying of lymphoid precursor cells, and differentiation in the genetic
alterations. The incidences of the disease occurring in the peak one is during the childhood while
the peak two occurs at about fifty years of age. Significant improvements have been made due to
dose intensification plans for pediatric patients; however, the elderly people who have ALL are
often unable to endure such regimens; hence their prognosis is still so poor (Terwilliger &
Abdul-Hay, 2017). Over the last 50 years, progress in treatment and understanding of the disease
has been constant.
Pathophysiology of the disease.
The pathogenesis of the Acute Lymphoblastic Leukemia (ALL) involves the abnormal
multiplying of the lymphoid cells. Through the studies made, genetic syndromes that incline to
the marginal cases were identified in the population of pediatric. These genetic syndromes
include; Fanconi anemia, bloom, and down syndromes. Pesticides, disclosure to ionizing
radiation, and some viruses are the predisposing factors. In most acute Lymphoblastic Leukemia
cases; however, in previously healthy persons, it appears as a de novo malignancy. The
Unusualness of the chromosomes is the symbol that marks ALL; however, they are not sufficient
to cause leukemia. The presentation of ALL cannot be specific as it is a constitutional
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combination of failure in bone marrow signs. The common symptoms include; night sweats, loss
of weight, bruising, fever and fatigue.
Involvement of extramedullary site often happens, and in patients, it can cause
lymphadenopathy and splenomegaly. Diagnosis is proven by about twenty percent or more
lymphoblasts in either the bone marrow or the blood cell. To confirm the risk stratification and
diagnosis, testing is so important. During the diagnosis period to assess CNS involvement,
lumbar puncture is standard for care with CSF examination.
Normal structures/functions affected by the disease
Acute Lymphoblastic Leukemia first invades an individual's blood and may spread to
other organs of the body such as the lymph nodes, spleen, and liver. However, unlike other types
of cancer, ALL does not make tumors. This disease develops disorders in the bone marrow cells
causing continuous cell growth and division. This leads to a sudden stop in the cell division of a
healthy cell, and hence the cell eventually dies. When the cell dies, the manufacture of the blood
cells becomes unusual. The disease also causes the presence of immature blast cells in the bone
marrow. The crowd of abnormal cells in the bone marrow henceforth prevents and affects the
manufacture of the Red blood cells, which is vibrant in the body for oxygen carriage. The
creation of platelets responsible for blood clotting is also affected. Nevertheless, the creation of
other white blood cell types is affected; for instance, the neutrophils that fight bacteria.
Normal changes of body system across the lifespan
Not all the patients diagnosed with having ALL exhibit the same body system changes.
Some of these body changes occur commonly than others, while some significantly affect the
patient's prognosis. According to the studies, about 25% of children and 75% of adults with
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Acute Lymphoblastic Leukemia are diagnosed to have hyperdiploidy, which is having a more
diploid number of chromosomes as the usual number. The genetic change in either the gain or
loss of chromosomes changes the typical chromosomes' development and functioning in the
body system (Zubair, Ashraf & Afzal, 2018). Therefore, age affects the changes in body systems
across the lifespan as young people have a better prognosis.
Changes related to disease processes across the lifespan.
During the disease's treatment process, intensive remission, which is followed by a post-
remission consolation, has achieved survival rates of about three years in adults with ALL.
However, some patients with specific abnormalities in chromosomes have high risks of failing to
complete remission. Nevertheless, parallel improvements are being made, which will contribute
to better survival rates of ALL patients in supportive care.
Diet changes/ education related to the disease process as they relate to multiple age groups
Diet change plays a critical role in coping and in the process of treatment of ALL.
Women who are pregnant are advised to consume a diet rich in proteins and vegetables to reduce
the chances of the offspring from contracting childhood Acute Lymphoblastic Leukemia. The
substantial portion of childhood ALL originates from chromosomal translocation and can be
prevented through proper maternal diet to reduce the risk to children.
However, in adults, exercise and a well-balanced diet are essential; therefore, the Diet and
Acute Lymphoblastic Leukemia Treatment is a group study exploring the diet intake for ALL.
The caloric preferences for each age and sex category are the met caloric intakes, the under
caloric intakes, and the caloric intakes that exceed the recommended values (Warris, Aarsen &
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Van den Heuvel-Eibrink, 2017). Exercising is so essential, and therefore the body requires lots of
energy, which can be produced by adequate carbohydrate intakes.
Patients coaching about health maintenance, compliance with treatment, and community
resources.
To maintain the patients’ health, the clinicians, and other healthcare staff plays a role in
coaching the patients in a complicated and stressful environment. In supporting their efforts in
coaching patients, the clinicians are aligned with poor structure, incentives, and culture systems.
However, in their coaching, they supply information and advice in treatment and intervention
based on their scientific expertise.
Moreover, the patients’ families and friends are essential in caregiving for individuals
with Acute Lymphoblastic Leukemia. The parent or guardians are the primary caregivers to
children having ALL as they have a new range of responsibilities in providing a well-balanced
diet. Since the treatment of ALL can be expensive, community resources are often used. This
brings stress and anxiety to the family in offering treatment costs, which leads to unplanned
expenses in the community. To manage their finances and comply with the patients’ treatment
plan, the community has to talk to the health care team about financial concerns.
Cultural considerations
Cultural competence is working effectively in a situation where there is cross-culture. It
is hard for most clinicians and doctors to treat patients with ALL, as understanding the different
cultural considerations may be difficult. However, it is necessary to provide proper healthcare
services concerning people's health beliefs, cultural needs, and practices. Moreover, different
cultures have diverse views on life, and all need to be appreciated.
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No matter the patient's culture, the effect of death on the family and friends, is the same.
Though, the differences lie in the family hierarchy and the person who makes most of the
decisions in the family information prognosis. The family members should not be given the end-
to life decision as the people will lose their belief in the health care staff. Thus, the medical staff
should do their best in treating the patient to reduce suffering and pain.
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References
Terwilliger, T., & Abdul-Hay, M. J. B. C. J. (2017). Acute lymphoblastic leukemia: a
comprehensive review and 2017 update. Blood cancer journal, 7(6), e577-e577.
Zubair, M., Khadim, S., Razzaq, T., Ashraf, T., Riaz, M., Alam, N., & Afzal, S. (2018).
Epidemiology of Acute Lymphoblastic Leukemia with reference to prevalence and
genetics. GSJ, 6(11).
Warris, L. T., van den Akker, E. L., Bierings, M. B., van den Bos, C., Aarsen, F. K., Zwaan, M.
C., ... & van den Heuvel‐Eibrink, M. M. (2017). Eating behavior during dexamethasone
treatment in children with acute lymphoblastic leukemia. Pediatric Blood &
Cancer, 64(12), e26679.
