Acute Lymphoblastic Leukemia (ALL)

University of Dammam Click toCollege ofsubtitle style edit Master Medicine Clinical Pharmacology March - 2012 Moayd
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17/3/20

Contents

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Acute Leukemia: is the presence of

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Pathogenesis of Acute Leukemia

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ALL accumulation Lymphoblasts

of

Clinical features

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Clinical features
2- Organ infiltration

Tender Bones Lymphadenopathy Moderate splenomegaly and/or hepatomegaly Meningeal syndrome (headache, nausea and vomiting, blurring of vision diplopia) Papilledema and hemorrhage

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Case Study
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Case Study
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Case Study
A 6 years old boy reports to medical unit complaining of:

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On Examination: Pallor and weak Petechial hemorrhages in the skin Gums hypertrophy and easily bleeding Tender long Bones Perianal ecchymosis and inflammation

Case Study

Pulse: 120 beats/minute BP: 110/70 mmHg Body Temperature: 39 C 5/22/12

Blood Examination:

Case Study

Low Hb ( 7 g/dl ) (Anemia) Total Leukocyte count: 50 x 106 /ml (Leukocytosis) Absolute neutrophil count (ANC): 500 /ul
(Neutropenia)

Platelets: 50,000 /ul (Thrombocytopenia)

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1- Bone marrow failure: Anemia (Fatigue, Pallor, weak and low Hb) Moderate Neutropenia (Fever, ANC: 500 /ul) Thrombocytopenia (Epistaxis, bleeding gums hypertrophy, Petechial hemorrhages, Perianal Logo Company ecchymosis and inflammation) 2- Organ infiltration: 5/22/12

Patients problem list

1- General supportive therapy A- Insertion of a central venous catheter B- Blood product support (Platelet & RBC) C- Haemostatic support (Cryoprecipitate) D- Antiemetic therapy (Ondansetron Company Logo or Granisetron + Dexamethasone) E- Prevention of Tumor lysis syndrome 5/22/12
(Allopurinol, IV Fluids & electrolyte

Therapeutic Objectives

Therapeutic Objectives 2- Specific therapy of ALL(Contd) (Chemotherapy and sometimes radiotherapy)

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Typical treatment regimen of ALL

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Prescription
(Remission Induction)

Name: **** *** ****** Age: 6 years Gender: Male File No. : ########## Date: 17/3/2012 Dx: Acute Lymphoblastic Leukimia Rx: 1- Vincristine, 1.5 mg/m2 IV; not to exceed 2 mg/dose 2- Asparaginase 6000-25,000 U/m2 IM 3 times/wk 3- Dexamethasone 40 mg/m2/d PO divided tid 5/22/12

Instructions and follow up

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Resources

Basic and Clinical Pharmacology, Katzung, 11th edt. Essential Haematology, A.V. Hoffbrand, 5th edt. British National Formulary, March 2011, 61th edt.
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Questions?
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Thank you !
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Appendix
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