chemotherapy

Question 1

What is the gold-standard treatment for leukemia?

Answer 1

Chemotherapy

Question 2

How many stages are in leukemia chemotherapy?

Answer 2

Three stages

Question 3

What is induction therapy?

Answer 3

Very first line of therapy for leukemia

Question 4

What is the goal of induction therapy?

Answer 4

Destroy leukemic cells in tissues, peripheral blood, and bone marrow

Question 5

What happens to the bone marrow during induction therapy?

Answer 5

Becomes severely depressed → patient may become critically ill

Question 6

What is the remission rate after one course of induction therapy?

Answer 6

~70% achieve complete remission

Question 7

What hematologic change is common during induction therapy?

Answer 7

Neutropenia

Question 8

What is intensification therapy?

Answer 8

High-dose therapy started immediately if induction did NOT achieve remission

Question 9

How long does intensification therapy last?

Answer 9

Several months

Question 10

What is consolidation therapy?

Answer 10

Given after remission is achieved following induction (for those in the ~70%)

Question 11

What does consolidation therapy consist of?

Answer 11

1–2 additional courses of the same drugs used in induction

Question 12

What is the purpose of consolidation therapy?

Answer 12

Eliminate remaining leukemic cells not clinically evident

Question 13

What is the goal of maintenance therapy?

Answer 13

Keep the body free of leukocytic cells

Question 14

When is maintenance therapy used?

Answer 14

In some acute leukemias depending on cytogenetic markers

Question 15

What is the standard chemotherapy approach for leukemia?

Answer 15

Combination drug therapy

Question 16

What are the three purposes of combination therapy?

Answer 16

↓ Drug resistance, ↓ toxicity, interrupts cell cycle at multiple points

Question 17

What is the mnemonic from the notes?

Answer 17

“That wombo combo boom pow pow”

Question 18

Besides chemotherapy, what other treatments may be used?

Answer 18

Corticosteroids, radiation, immunotherapy, HSCT

Question 19

What does HSCT stand for?

Answer 19

Hematopoietic Stem Cell Transplant

Question 20

What is graft-vs-host disease?

Answer 20

The body rejects the donated stem cells

Question 21

Can relapse still occur after HSCT?

Answer 21

Yes

Question 22

Why are patients highly susceptible to infection after HSCT?

Answer 22

Their entire body is radiated, eliminating WBCs → no immune defense

Question 23

What major risks occur due to immunosuppression after HSCT?

Answer 23

Infection and sepsis

Question 24

What are key clinical problems in leukemia patients?

Answer 24

Anemia, thrombocytopenia, neutropenia

Question 25

What neutrophil count is concerning?

Answer 25

< 4 (neutropenia)

Question 26

What infection-prevention measures must be taken?

Answer 26

No fresh flowers, wear a mask around them, hand hygiene — we are the danger to them

Question 27

What psychosocial problems may occur?

Answer 27

↓ Quality of life, family stress, family needs

Question 28

What education should the nurse provide?

Answer 28

Treatment plan explanations (doctor decides plan, but nurse can answer next-step questions), side effects, available resources