MedClips

Causes There are three major causes of Thrombocytopenia. First, there is a decrease in bone marrow production. If there is a problem in bone narrow, factors such as BM failure, adverse effect of drug, and BM infiltration can be considered. The second is splenic sequestration by splenomegaly. One-third of the platelets usually pass through the liver and spleen, and splenomegaly can increase this amount, reducing the number of platelets in the peripheral blood. Liver cirrhosis, leukemia, splenic vein thrombosis, and portal hypertension may cause splenomegaly. Finally, when platelet destruction increases, thrombocytopenia may occur, which can be further divided into immune destruction and non-immune destruction. Immunologic thrombocytopenia is caused by the removal of monocytes from the spleen of the pletelets that bind the antibody, immune complexes, and complement. The most common cause is infection and autoimmune diseases such as drug, ITP and SLE can also be induced. Non-immunologic ...

If AML is diagnosed, the following treatments should be given to the patient. Long-term use of anthracycline and cytarabine, such as daunorubicin and idarubicin, has been suggested as induction chemotherapy, and etoposide or 6-thioguanide may be used recently. However, its advantages are unclear. Studies have shown complete remission (CR) in more than 70% of all AML patients when the following treatments were administered: To maintain this condition, consolidation is required, which involves the use of two courses of high dose cytarabine (HiDAC), or allogenic hematopoietic cell transplantation (HCT) to patients with high risk cyhtogenetics on the first CR. It is recommended that HCT be used as a consolidation treatment even in patients who have received chemotherapy such as cyclophosphamide or etoposide or who have undergone radiotherapy. In fact, it is known that HCT significantly reduces the risk of recurrence of AML, but there is a question about whether it increases survival rate b...

In patients with leukemia, chemotherapy induces bone marrow suppression and causes the majority of patients to develop Neutropenia. Because these patients have much immune function, serious infections can be seen without any symptoms other than fever have. These infections can go on rapidly and can pose a life threat to your patients, so you should be familiar with Neutropenic fever. Definition Neutropenic fever is defined as Neutropenic fever when Fever and Neutropenia are simultaneously present. Fever can be diagnosed as Fever when the body temperature above 38 degrees Celsius lasts for more than 1 hour (different standard for each hospital) and Neutropenia when ANC is below 1500. Symptoms & Causes Even patients with the same neuroprotective fever have different risks, but the risk is assessed differently depending on the patient's condition and situation. At this time, the MASCC (Multinational Association for Supportive Care in Cancer) is the score. 5 points each when...

Symptoms Burkitt lymphoma is a very aggressive B cell non-Hodgkin lymphoma characterized by endemic, epidemic (sporadic), immunodeficiency-associated ) Can be classified into three. It is known that genetic causes caused by translocation and deregulation of c-MYC gene on chromosome 8 are closely related to Epstein-Barr virus infection. The prognosis is good because it is a lymphoma with a good response to chemotherapy. Patients with Burkitt lymphoma have a very rapid rate of tumor growth and spontaneous tumor lysis. Therefore, serum levels of lactate dehydrogenase and uric acid levels are rising. There were three epidemiological classifications of Burkitt lymphomas, with distinct clinical manifestations in each group. First, endemic type tumors are usually found in the jaw or facial bones. Tumor is rarely the first occurrence in the abdomen. Primary tumors of the facial nerve can be transferred to mesentery, ovary, testis, kidney, breast, meninges, and the like. Primary tumors in the...

Symptoms Leukemia is the most common cancer among childhood cancers. Among them, Acute lymphoblastic leukemia (ALL) is the most common cause, and ALL is the most common cancer among childhood cancers. Clinical symptoms of ALL are very nonspecific. Fever, hemorrhagic tendency, bone pain, enlargement of the lymph nodes, and splenomegaly. If these nonspecific symptoms persist without resolution, ALL should always be suspected in children. Diagnosis ALL can be classified as morphological, CD marker, or cytogenetic. The morphological classification follows the FAB classification and is classified into L1, L2, and L3 according to the shape through the Bone marrow biopsy. CD markers can be used to determine whether this ALL is a T cell lineage or B cell lineage. Most of ALL is B cell lineage, and the T cell lineage has a poor prognosis. The cytogenetic classification is based on chromosomal studies to classify ALL based on chromosomal anomalies or presence or absence of genes. Philadelphi...

Symptoms The symptoms of non-Hodgkin's lymphoma (NHL) vary greatly depending on the type and extent of involvement. In general, aggressive lymphoma is characterized by a rapidly enlarging mass, systemic B symptoms, elevated serum lactate dehydrogenase (LDH) and uric acid. These aggressive lymphomas include diffuse large B cell lymphoma, Burkitt lymphoma, mature T cell lymphoma, and precursor B or T lymphoblastic lymphoma. Indolent lymphoma may be a slowly growing mass, liver and spleen enlargement, and cytopenia. These lymphomas include follicular lymphoma, small lymphocytic lymphoma, and marginal zone lymphoma. About 40 percent of NHL patients have systemic symptoms called B symptoms. B symptoms means fever over 38 degrees, weight loss over 10 percent for 6 months, night sweats. These symptoms are more pronounced in aggressive lymphoma and are associated with prognosis. Also, lymphadenopathy appears in more than two thirds of NHL patients. Lymphadenopathy is often seen to be r...

High dose & intrathecal Methotrexate (MTX) is often used for consolidation and CNS relapse prevention because it has been reported to improve the outcome of ALL therapy. However, MTX has side effects such as inhibition of myelin synthesis, antisera, oligodendrocytes, and BBB function. The most serious side effect of MTX is neurotoxicity, which may cause a side effect of up to 3-15% of the total treated patients, which may be transient, but may require occasional coma or death. Subacute effects can be divided into acute, subacute, and chronic neurotoxicity syndromes depending on the time that side effects occur due to IV and IT use. Acute-phase side effects include somnolence, confusion, headache, nausea, vomiting, and dizziness within several hours after IV administration of high-dose chemical meningitis and within several hours after ITx MTX treatment. Chronic side effects appear within a few months after MTX administration, and symptoms such as cognitive decline, abnormal behavi...

Dental treatment in patients with leukemia. Zimmermann C, Meurer MI, Grando LJ, Gonzaga Del Moral JÂ, da Silva Rath IB, Schaefer Tavares S. PMID: 25784937 Neutrophil and platelet counts play a major hematologic index in predicting bleeding, infection risk, and whether to perform dental procedures. There are no internationally accepted protocols, but several recommendations have been published. (Table 2) Generally, antibiotic prophylaxis is required when the neutrophil count is less than 1,000 cells / mm3, and transfusion is recommended when the platelet count is 40,000-60,000 cells / mm3. Dental procedures can be divided into six groups according to the degree of invasiveness. Types I and II are noninvasive procedures, and patients can be enrolled at any time before, during, and after chemotherapy. In this case, the patient is in the transchemotherapy group because of the fact that the consolidation therapy will be started immediately after the induction therapy 2 weeks after th...