general principles in management of leukemia

GENERAL PRINCIPLES IN MANAGEMENT OF LEUKEMIA

Leukemia being a form of cancer, the decision to treat a patient with curative intent depends on the persons age, their general state of health the time point in the course of the illness (presentation or recurrence), and the persons wishes.


  •      Anemia and thrombocytopenia need to be corrected by administration of blood and platelets.  
  •      Infections treated with intravenous antibiotics
  •      Leucophoresis- done when the blast cell count is too high in peripheral blood- blood is harvested from one major vein, centrifuged to remove leukemic cells, and the red cell and plasma are returned to patient via another vein.
  •      Administer allopurinol-a xanthine oxidase-inhibitor to treat or prevent hyperuricemia
  •      Give intravenous fluids before chemotherapy sessions.
  •        Dialysis should be available to help correct metabolic imbalance (especially after chemotherapy).
  •        Ensure a good supply of blood products and relevant antibiotics as supportive therapy to the specific treatment being given.

In cases where the rate of cell proliferation is high, patients may develop a tumor lysis syndrome when chemotherapy is given. It is characterized by hypercalcemia, and high phosphate and potassium that results from the high rate of cellular breakdown. It is potentially dangerous and so hard to treat and therefore the medical team should ensure that chemotherapy is not started until the uric acid level is normal and that all biochemical parameters are monitored throughout the course of treatment.


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