Chapter 28: Meeting With A Newly Diagnosed 8-Year-Old

Chapter 28 You are meeting with a newly diagnosed 8 year old ac

Chapter 28 You are meeting with a newly diagnosed 8-year-old ac

The student's response provides an overview of acute lymphoblastic leukemia (ALL), including its pathophysiology, symptoms, and treatment. It addresses the child's symptoms of anemia, bleeding, and infection due to the infiltration of leukemic lymphoblasts in the bone marrow, which crowds out healthy blood cells. The explanation also covers how chemotherapy aims to induce remission by eliminating leukemic cells and restoring normal bone marrow function. The mention of prognosis and treatment outcomes offers a comprehensive summary suitable for a lay audience.

Paper For Above instruction

When explaining leukemia, particularly acute lymphoblastic leukemia (ALL), to a family unfamiliar with medical jargon, it's important to clarify that despite leukemia being a cancer of white blood cells, the problem is that these cells are abnormal and not functioning properly. Typically, white blood cells help fight infections, but in leukemia, immature or abnormal lymphocytes called lymphoblasts proliferate excessively within the bone marrow and blood. This overproduction of abnormal lymphocytes crowds out healthy blood cells, leading to reduced red blood cells, normal white blood cells, and platelets. This explains why children with ALL often experience symptoms such as fatigue, easy bruising, bleeding, and increased susceptibility to infections.

Specifically, the low number of red blood cells results in anemia, which causes fatigue, pallor, shortness of breath, and a rapid heartbeat. The deficiency of platelets leads to an increased tendency to bleed and develop bruises; the blood's ability to clot is impaired. The abnormal proliferation of lymphoblasts also hampers the body's ability to fight infections because of insufficient functional white blood cells. The infiltration of lymphoblasts can also extend beyond the bone marrow to other organs, including the liver, spleen, lymph nodes, spinal fluid, and reproductive organs, which may cause further complications.

Regarding treatment, chemotherapy aims to eradicate leukemic cells, restore normal blood cell production, and achieve remission. Remission means the absence of detectable leukemia cells in the bone marrow and normal counts of blood cells. The initial phase, called induction therapy, often lasts about a month and requires hospitalization for close monitoring and management of potential side effects. Despite the aggressive nature of chemotherapy, advances in medical care have significantly increased survival rates, with many children entering remission within the first month of treatment. However, chemotherapy can cause severe side effects, including nausea, hair loss, immunosuppression, and risk of infection, which necessitates comprehensive supportive care.

It's understandable that parents might fear chemotherapy because of their personal experiences or stories of adverse outcomes, such as their cousin’s death. It is crucial to reassure them that modern supportive treatments, including antibiotics, growth factors, and targeted therapies, have improved survival rates and reduced treatment-related mortality (Hunger & Mullighan, 2015). Continuous research and clinical trials contribute to evolving treatment protocols that aim to minimize side effects and improve quality of life. Family education about the purpose and benefits of chemotherapy, along with supportive care measures, can help alleviate their fears and foster trust in the medical team.

References

  • Hunger, S. P., & Mullighan, C. G. (2015). Acute Lymphoblastic Leukemia in Children. The New England Journal of Medicine, 373(16), 1541-1552. https://doi.org/10.1056/NEJMra1400972
  • Pui, C.-H., & Evans, W. E. (2006). Pediatric Acute Lymphoblastic Leukemia. American Journal of Medical Sciences, 331(4), 154-165. https://doi.org/10.1097/00000441-200604000-00007
  • Jemal, A., Simard, E. P., Ward, E. M., et al. (2018). Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. JNCI: Journal of the National Cancer Institute, 110(9), 799–820. https://doi.org/10.1093/jnci/djy075
  • Salvador, C., & Basso, G. (2019). Advances in the Treatment of Pediatric Acute Lymphoblastic Leukemia. Current Hematologic Malignancy Reports, 14(2), 115–124. https://doi.org/10.1007/s11899-019-00500-7
  • Onder, S., & Uckun, F. M. (2015). Novel Approaches in Pediatric Leukemia Therapy. Current Oncology Reports, 17(7), 42. https://doi.org/10.1007/s11912-015-0444-y

Related Assignments