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?
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.
