Leukemia: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
No edit summary |
||
(2 intermediate revisions by 2 users not shown) | |||
Line 1: | Line 1: | ||
{{Adult top}} [[leukemia (peds)]] | |||
==Background== | |||
*Hematologic malignancy that typically originates in bone marrow and results in high number of abnormal leukocytes or ''blasts'' | |||
===Types of Leukemia=== | ===Types of Leukemia=== | ||
*[[Acute myeloid leukemia]] | *[[Acute myeloid leukemia]] | ||
Line 6: | Line 9: | ||
*[[Leukemia (peds)]] | *[[Leukemia (peds)]] | ||
[[File:Celldifferentiation.jpg|thumbnail|Myeloid and Lymphoid lineage]] | [[File:Celldifferentiation.jpg|thumbnail|Myeloid and Lymphoid lineage]] | ||
==Clinical Features== | |||
*Varies by type | |||
===Complications=== | |||
*[[Tumor lysis syndrome]] | |||
*[[Neutropenic fever]], [[Sepsis]], overall increased risk of [[infection]] | |||
**[[Neutropenic enterocolitis (typhlitis)]] | |||
*[[Leukostasis and hyperleukocytosis]] | |||
*[[Hyperviscosity syndrome]] | |||
*[[Thromboembolism]] | |||
*Treatment-related complications | |||
**Chemotherapy-induced [[nausea and vomiting]] | |||
**[[Cytokine release syndrome]] | |||
**Chemotherapeutic drug extravasation | |||
**[[Differentiation syndrome]] ([[retinoic acid syndrome]]) in APML | |||
**[[Stem cell transplant complications]] | |||
**Catheter-related complications | |||
**Tunnel infection | |||
***Exit site infection | |||
***CVC obstruction (intraluminal or catheter tip thrombosis) | |||
***Catheter-related venous thrombosis | |||
***Fracture of catheter lumen | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{DDX leukocytosis}} | {{DDX leukocytosis}} | ||
==Workup Consideration== | |||
*[[CXR]] | |||
*CBC with peripheral smear | |||
*[[Tumor lysis syndrome]] labs: chem7, ca, mg, phos, uric acid, [[UA]], LDH | |||
*[[DIC]] labs: [[LFTs]], Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen | |||
*ESR, CRP | |||
*Reticulocyte count in anemia | |||
*Get extra purple top for flow cytometry, especially before transfusion | |||
==Management== | |||
*Address any complications | |||
*Consult oncology for new diagnosis | |||
==See Also== | ==See Also== |
Latest revision as of 23:31, 28 November 2019
This page is for adult patients. For pediatric patients, see: leukemia (peds)
Background
- Hematologic malignancy that typically originates in bone marrow and results in high number of abnormal leukocytes or blasts
Types of Leukemia
- Acute myeloid leukemia
- Chronic myeloid leukemia
- Acute lymphocytic leukemia
- Chronic lymphocytic leukemia
- Leukemia (peds)
Clinical Features
- Varies by type
Complications
- Tumor lysis syndrome
- Neutropenic fever, Sepsis, overall increased risk of infection
- Leukostasis and hyperleukocytosis
- Hyperviscosity syndrome
- Thromboembolism
- Treatment-related complications
- Chemotherapy-induced nausea and vomiting
- Cytokine release syndrome
- Chemotherapeutic drug extravasation
- Differentiation syndrome (retinoic acid syndrome) in APML
- Stem cell transplant complications
- Catheter-related complications
- Tunnel infection
- Exit site infection
- CVC obstruction (intraluminal or catheter tip thrombosis)
- Catheter-related venous thrombosis
- Fracture of catheter lumen
Differential Diagnosis
Leukocytosis
- Normally responding bone marrow
- Infection
- Inflammation: tissue necrosis, infarction, burns, arthritis
- Stress: overexertion, seizures, anxiety, anesthesia
- Drugs: corticosteroids, lithium, beta agonists
- Trauma: splenectomy
- Hemolytic anemia
- Leukemoid malignancy
- Abnormal bone marrow
Workup Consideration
- CXR
- CBC with peripheral smear
- Tumor lysis syndrome labs: chem7, ca, mg, phos, uric acid, UA, LDH
- DIC labs: LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen
- ESR, CRP
- Reticulocyte count in anemia
- Get extra purple top for flow cytometry, especially before transfusion
Management
- Address any complications
- Consult oncology for new diagnosis