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CC Jan 2016 Acute Myelogenous Leukemia in Children

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echoecho's version from 2016-01-05 17:43

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Question Answer
Although rare, ______ is the second leading cause of death in children in developed countries?cancer
Unfortunately, s/s of childhood cancers are often vague and may represent more common and/or minor illnesses, true or false?true
*** The provider should be aware of red flags for childhood cancer when patients present with vague, yet persistent s/s. List these red-flag s/s?1) persistent low-grade fever 2) pallor 3) fatigue 4) anorexia 5) petechiae 6) bruising or gingival bleeding 7) bone pain (generalized or involving the joints) 8) recurrent or persistent infection 9) irritability
*** Although no one sign is indicative of leukemia, the combination of multiple s/s that are persistent and not attributable to another etiolgy warrant further evaluation. What additional testing should be ordered?CBC with peripheral blood smear
List the red flags for neuroblastoma?1) palpable abdominal or neck mass 2) fever 3) malaise 4) failure to thrive 5) bone pain 6) neurologic s/s
List the red flags for rhabdomyosarcomas?1) palpable masss 2) s/s resulting from mass effect on adjacent structures 3) occasionally LAD
List the red flags for Wilms tumors?1) abdominal pain 2) fever 3) vomiting 4) constipation 5) hematuria
List the red flags for Ewing's sarcomas?1) prolonged fever 2) long bone pain 3) fatigue 4) weight loss
Leukemia is the most common form of childhood cancer, accounting for ___% of cancer diagnoses?30%
What leukemia represent 18% of childhood leukemias?AML (acute myelogenous leukemia)
What leukemia represents 82% of childhood leukemias?ALL (acute lymphocytic leukemia)
Describe AML (acute myelogenous leukemia)?1) results from the development of abnormal hematopoietic progenitor cells that prevent the development of mature blood cell elements including red cells, white cells and platelets 2) white cell counts are markedly elevated, yet these white cells are ineffective, making patients prone to infection 3) red cell counts and platelets are diminished, contributing to pallor and petechiae 4) peripheral smear demonstrates a preponderance of blast cells
Comment on the risk factors of AML?these are poorly understood
Treatment responses have significantly improved over the past 3 decades, with a 5-year cure rate of _____% in children < 15 years of age?64%
The effectiveness of treatment varies greatly (from 22-90%) due to what?AML subtypes and initial response to chemotherapy
The current regimen for AML consists of what?1) 2 cyles fo induction therapy using daunomycin, cytosine arabinoside and etoposide (ADE) therapy)
What is an antibody that is currently under study for treatment of AML?Gentuzumab ozogamicin (anti-CD33 antibody)
Since more than ____% of patients relapse WITHOUT post-induction treatment, induction is followed by consolidation / intensification therapy with high-dose chemotherapy for several months?90%
Both allogeneic and autologous bone marrow transplants reduce ______ but do not necessarily improve survival?relapse
*** SUMMARY = WBC are markedly _____ , yet these white cells are ineffective, making patients prone to what?elevated; infections
*** SUMMARY = Treatment responlses have significantly improved over the past 3 decades,with a 5 year survival cure rate of ____% in children < 15 years of age?64%
*** SUMMARY = Since more than 90% of patients relapse without post-induction treatment, induction is followed by what therapy with high-dose chemotherapy for several months?consolidation / intensification therapy
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