| Introduction
Measuring
WBCs
Myeloid
Leukemias
Lymphoid
Leukemias
Sources
of Error
Quiz
Please |
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There's
still work to be done with ALL.
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Things that are consistently
associated with a poor outcome
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Age under 2 years
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For the most part adults
and adolescents have a lousy outcome compared to children.
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The presence of the Philadelphia
chromosome t(9;22)
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Bone marrow transplant is just
about the only hope for those in this group.
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Other problems people experience
while under treatment.
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Life threatening infections
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Cerebral hemorrhage
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Unfortunately Gleevec
doesn't work for ALL as it does for CML.
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The potential for renal failure.
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Because the chemotherapy is
so effective, there is a tremendous number of dying blasts almost
immediately.
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The DNA breakdown from
the dying cells will quickly overwhelm purine metabolism.
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Uric acid levels can
go through the roof during initial therapy.
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If the patient is not pre-medicated
with with an anti-uric acid drug (just like we use for gout) the uric
acid levels will be so high it will crystallize in the renal tubules and
interstitial tissue, causing
acute tubular
necrosis (ATN).
It's the home stretch, here
comes chronic lymphocytic leukemia.
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