Chapter 11: Malignant Disorders of White Blood Cells

The peak incidence for ALL occurs between

3 to 7 years old

The median age of presentation of AML

64 years

The average age of patients with CLL is

65 to 70 years

A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis

ALL (acute lymphoid leukemia)

Which type of leukemia primarily affects children

ALL (acute lymphoid leukemia)

In general, the best prognosis for long-term disease-free survival occurs with

ALL (acute lymphoid leukemia) is highly curable in the pediatric population with an 85% survival rate in children

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine

Which viruses have been implicated as cancer-causing agents? (Select all that apply.)

Epstein-Barr Human T-cell leukemia Human immunodeficiency

Burkitt lymphoma is most closely associated with

Epstein-Barr virus

A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.)

Fatigue Weight loss Abdominal discomfort Sweats

Enlarged cervical lymph nodes are seen more commonly in

Hodgkin disease

A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.)

Liver Spleen Kidneys

Bence Jones protein

Multiple myeloma is also known to accumulate in the kidneys and cause kidney damage

Renal insufficiency is a common complication of which disease?

Myeloma

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

activity restriction.

A patient is diagnosed with hairy cell leukemia. The patient's laboratory results would most likely indicate a decrease in (Select all that apply.)

granulocytes platelets melanocytes

The major cause of death from leukemic disease is

infection

The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is

infection

Asymptomatic onset is generally found with

CLL and is often found by accident on a routine blood count

\Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

CML (chronic myeloid leukemia)

What is the correct definition of complete remission (CR) of leukemia?

CR is less than 5% blasts in marrow and normal CBC values. and be maintained for at least 4 weeks

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

Pain in long bones, infection, fever, bruising

A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient's cancer? (Select all that apply.)

Radiation Bone marrow transplant Chemotherapy Monoclonal antibody therapy

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor

T

Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord

T Compression of the spinal cord is one of the two most serious oncology emergencies associated with non-Hodgkin lymphoma.

CLL is associated with

T-cell transformation

NURSINGTB.COM Complete remission (CR) is

a return to normal hematopoiesis

The onset of symptoms of ALL is

abrupt and may begin when a child refuses to walk or begins to exhibit loss of appetite, fatigue, or abdominal pain

The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.)

anemia. leukocytosis thrombocytopenia

The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

bcr-abl.

Average onset of CML is

between 40 to 50 years

NURSINGTB.COM The majority of CML cases are characterized by

malignant granulocytes that carry the Philadelphia chromosome

A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is

myeloma

A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.)

patient history CT scan physical examination

allogeneic transplant

person giving bone marrow or stem cells is genetically matched family member (usually brother or sister)

Vertebral fractures, elevated calcium levels, and bone pain are more frequently associated with

plasma cell myeloma.

Autologous stem cell transplantation is a procedure in which

stem cells are harvested from the patient and then returned to the same patient.

ALL is manifested by

the malignant transformation of B cells and some T cells