Leukemias Overview: NCLEX Priorities
ALL, AML, CLL, CML: who gets what, key treatments, neutropenic precautions.
Four main leukemias. NCLEX tests recognition patterns and neutropenic precautions.
ALL
Acute lymphoblastic. Most common childhood cancer. Highly treatable with chemo. CNS prophylaxis.
AML
Acute myeloid. Adults. Aggressive chemo, possible BMT. Auer rods on smear (M3 subtype).
CLL
Chronic lymphocytic. Elderly. Often indolent, watch and wait. Targeted therapy (ibrutinib) if progressing.
CML
Chronic myeloid. Philadelphia chromosome (BCR-ABL). Tyrosine kinase inhibitors (imatinib) transformed treatment.
Neutropenic precautions
Private room, hand hygiene, no fresh flowers/raw fruits/uncooked meats, avoid crowds, monitor temperature closely. Neutropenic fever (T>38.3, ANC <500) is emergency, blood cultures, broad antibiotics.
Frequently asked
Tumor lysis syndrome?
Massive cell death → high K+, high phos, high uric acid, low calcium. AKI risk. Hydrate, allopurinol/rasburicase.
Why CNS prophylaxis in ALL?
Sanctuary site. Intrathecal methotrexate.
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