Leukemia: Nursing process (ADPIE)

Taylor Oscar is a 64-year-old male who presents to the clinic with a 3-week history of extreme fatigue, bruising, and flu-like symptoms.

Laboratory findings reveal a white blood cell count of 18,000/mm3 with 40 percent blasts, hemoglobin 12.6 g/dL, and platelets 112,000/mm3.

A bone marrow biopsy and aspirate is performed, which confirms a diagnosis of acute myeloid leukemia or AML.

Taylor is emergently admitted to the hematology oncology unit to begin treatment for AML.

Leukemia refers to a group of cancers that can occur when there’s uncontrolled proliferation of non-functional white blood cells, or WBCs, in the bone marrow.

This differentiates leukemias from lymphomas, which can also arise from WBCs, but they typically form solid tumors in lymphatic tissue, such as lymph nodes, thymus, or spleen.

Leukemias are grouped by how quickly the disease develops. Acute leukemia develops very quickly, over days to weeks, so the WBCs don’t mature at all, and usually remain in the earlier “blast” form.

On the other hand, chronic leukemia develops slowly, over many months or years, so the non-functional WBCs have time to mature partially.

Now, leukemias can be further grouped based on the cell type involved. Myeloid leukemias are caused by proliferation of cells from the myeloid cell line, such as monocytes or granulocytes, which include eosinophils, basophils, and neutrophils.

On the other hand, lymphoid leukemias are caused by the proliferation of cells from the lymphoid line, which includes B- and T- cells.

So overall, there’s acute myeloid leukemia, or AML; and acute lymphoblastic leukemia, or ALL; as well as chronic myeloid leukemia, or CML; and chronic lymphocytic leukemia or CLL.

Now, leukemias are thought to be caused by mutations in the precursor blood cells in the bone marrow, leading to uncontrolled proliferation.