Hello. We will be discussing leukemia and its pathophysiology with its different types.

What is leukemia?

Leukemia is cancer in the blood. “Leuk” came from the immature white blood cells known as blasts; while “-emia” means condition. Basically, what happens with leukemia is that there is an increased production of blood which caused crowding inside the bones.

Normally, the stem cells in the bones are mainly responsible for creating blood cells – red and white blood cells and platelets.  In leukemia, there is an overproduction of white blood cells (WBC). You can think of it as having too many policemen inside a restaurant, causing overcrowding and disproportion with other blood cells.

What should you watch out for with clients that have leukemia?

1. Elevated WBC count, extremely high
2. Bone pain due to the pressure of overcrowding inside your bones
3. Decreased numbers in the other blood cells (platelets, red blood cells, hemoglobin, hematocrit)

What are the different kinds of leukemia?

There are technically four classes of leukemia – the acute and chronic myelogenous leukemia and the acute or chronic lymphoid leukemia. These types mainly depend on how fast the production of white blood cells is in the body.

AML and CML

In a person’s blood stem, there are also different types of white blood cells, one of which is the myeloid stem cells.

Overproduction of the myeloid stem cells causes acute and chronic myelogenous leukemia. Acute myelogenous leukemia (AML) is the rapid production of white blood cells in a course of a few days. On the other hand, chronic myelogenous leukemia (CML) took weeks or months for the white blood cells to increase.

ALL and CLL

Much like AML and CML, if the problem started with the lymphoid cells, it progresses into either an acute or chronic leukemia – basically known as your acute lymphoma or lymphocyte leukemia (ALL) and chronic lymphoid leukemia (CLL).

Signs and Symptoms 

Regardless of leukemia type, whether it originated form the myeloid stem cells or the lymphoid cells, the client is going to exhibit the following signs and symptsoms:

1. Decreased hemoglobin and hematocrit levels
2. Low platelet count
3. High white blood cell count
4. Bone pain
5. Paleness
6. Presence of hematomas

Test question tip

Nursing exams love to put in a particular question regarding your chronic myeloid leukemia (CML). There is a specific kind of test that primarily indicates the abnormality in leukemia cancer cells that pertains to CML. It’s called the Philadelphia Chromosome. And the main demographic that this affects are pediatric clients for some unknown reason.

Remember: If a particular disease cannot be explained or there are no specific reasons why the disease happened in the first place, it’s called as idiopathic; being idiots in the pathophysiology.

So, if you encounter nursing questions that states a client came in showing signs and symptoms stated above yet it’s idiopathic, the answer would most likely be chronic myeloid leukemia (CML).

On the next part, we tackle the main clinical manifestations of leukemia. We’ve already mentioned some but we’ll break it down further for you to properly understand what’s really causing all those manifestations when a person has leukemia.

See you on part 2!