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Chapter 28

You are meeting with a newly diagnosed 8-year-old acute lymphocytic leukemia (ALL) patient and his family to answer their questions about his illness and plan for treatment. They had sought medical treatment because the boy had experienced unusual fatigue, repeated infections, and unexplained bruising over the past few months.

a.            The patient and his family want to know why he has problems with bruising and infections when their understanding is that leukemia is a problem with too many white blood cells. How would you answer their question using lay language?

b.            The parents are very afraid of the chemotherapy regimen that is being planned, stating that their 40-year-old cousin died of ALL despite receiving powerful chemotherapy drugs that

Acute lymphoblastic leukemia (ALL) is a cancer of the lymphocytes, which are white blood cells that are in charge of the immune system. It is the most common type of cancer in children.
In the (ALL), the lymphoblasts provide the bone marrow and crowd out other normal cells, repressing the generation of red blood cells, several other types of white blood cells. If the bone marrow is not working correctly, the child may encounter anemia, simple bruising, bleeding, or infection.

Anemia is the result of reduced red blood cells. Anemia symptoms include tiredness, irritation, drowsiness, colorlessness, shortness of breath, and a rapid heartbeat.
When lesions occur it is difficult for blood to clot, so bleeding and bruises may happen more easily since there is a low flow of platelets. Additionally, an infection may happen often if the blood lack of normal white blood cells.
Lymphoblasts may also extend to other organs, including the skin, liver, spleen, the spinal fluid, and a girl’s ovaries, and a boy’s testicles

The purpose of chemotherapy in patients with acute lymphocytic leukemia is to achieve remission. As a result, leukemia cells are no longer seen in bone marrow samples, the normal marrow cells respond, and the blood counts become normal.  92% of children begin within a month of induction treatment to then start remission. Patients are required to stay in the hospital for treatment and daily doctor's check. Complications can be very severe to be life-threatening, but improvements in health care, have made the threat less probable.

References

 Treatment of Children With Acute Lymphocytic Leukemia (ALL). (n.d.). Retrieved from https://www.cancer.org/cancer/leukemia-in-children/treating/children-with-all.html

Pathak, N. (2017, September 8). Acute Lymphoblastic Leukemia (ALL): Survival, Treatments, and More. Retrieved from https://www.webmd.com/cancer/lymphoma/acute-lymphoblastic-leukemia#1.