Leukemia Assessment
- Immature WBCs
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- May Have Normal or High WBC Count
Leukemia Interventions
- Bone Marrow Aspiration
- X-Rays
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
Acute Myelogenous Leukemia (AML)
- Myeloblasts Increase on Peripheral Smear
- Median Onset 60 Years
- T 15;17 M3 Subtype
- Auer Rods
- Disseminated Intravascular Coagulation (DIC) is a Common Presentation
- M5 Gum Infiltration
- Responds to Vitamin A
Acute Lymphoblastic Leukemia (ALL)
- Ages < 15
- May Present with Bone Marrow Involvement in Children
- Mediastinal Mass in Adolescents
- TdT Positive
- CALLA Positive
- t(12;21) Better Prognosis
- Spread to CNS and Testes
- Most Responsive to Chemotherapy
Neuroblastoma Characteristics and Presentation
- Malignant Neuroendocrine Tumor
- Neural Crest Cells Origin
- Sympathetic Ganglia
- Adrenal Glands
- Amplification of N-myc Oncogene
- Most Common Cancer In Infancy
- Abdominal Mass That Can Cross Midline
- Gastrointestinal Distress
- Metastasis
- Raccoon Eyes
- Opsoclonus-Myoclonus Syndrome
Neuroblastoma Diagnosis and Management
- 24-hour Urine Test
- Increased Catecholamines
- Increased Homovanillic and Vanillylmandelic Acid
- Ultrasound
- Magnetic Resonance Imaging (MRI)
- Biopsy
- Small Round Blue Cells
- Homer-Wright Rosettes
- Bombesin Positive
- Neuron Specific Enolase Positive
- Local Excision
- Chemotherapy
- Radiation
Wilms' Tumor (Nephroblastoma)
- Malignant Renal Tumor
- Abdominal Mass
- Hematuria
- Fever
- Hypertension
- Nephrectomy
- Chemotherapy
- Radiation
- Do Not Palpate Abdomen
- Children Under 5 Years Old
Ewing's Sarcoma
- Most Common in Boys < 15 years old
- 11;22 Translocation
- Long bones, Pelvis, Ribs
- Diaphysis
- Small Blue Cells
- Malignant
- Aggressive
- Onion-skin Appearance
- Responsive to Chemotherapy
Osteosarcoma
- Osteogenic Sarcoma
- Peak incidence men 10-20 years old
- Metaphysis of Long Bones
- Knee Region
- Radiation
- Familial Retinoblastoma
- Paget's Disease
- Codman Triangle
- Sunburst Pattern from Elevated Periosteum
- Grave Prognosis
Langerhans Cell Histiocytosis
- Antigen Presentation Defect
- Lytic Bone Lesions
- Skull
- Hypopituitarism
- Diabetes Insipidus
- Skin Rash
- Recurrent Otitis Media
- Birbeck Granules
- "Tennis Racket" Appearance
- S100 Positive
- Observation
- Prednisone +/- Vinblastine