White Blood Cell Count example essay topic

Psychosocial Assessment Mr. L. is a 69 year-old male with acute myelogenous leukemia (AML), FAB-M 1 normal cytogenetics diagnosed in May of 2001. He received chemotherapy (7+3: AraC / idarubican) at that time and achieved complete remission. He developed a relapse in the April of 2002. He deferred treatment as he was trying alternative medicines. He eventually was treated with chemotherapy (Mylo targ) again in May of 2002, but this did not result in remission and he is considered to be in refractory relapse. Mr. L. has a history of neutropenia fever, otitis media, diabetes, positive VRE in his blood, and Coronary Artery Disease.

Mr. L does understand that there is no cure for his disease and that is why he has chose alternative care. He has refused a referral to UW-Madison & UI-Chicago for research and experimental therapy. At this time he is still trying alternative medicines, and comes into the Cancer Center for lab draws, and if needed he has blood and / or platelet transfusions. He has refused Pro crit and GM-CSF, to assist in his condition. Mr. L is married and his wife is supportive of him and his choice in attempting alternative medicine.

He also has many siblings who are supportive of him and 2 of them were tested for HLA compatibility to see if they would be able to help their brother and tested positive, although due to his remission it is not possible for him to have a transplant at this time. His stressors are having a disease that there is no know cure for, having chemotherapy not work, trying alternative therapies, and having to come into the Cancer Center each week to have his blood work tested (CBC & CMP) to see if he needs to be transfused. With all of this going on Mr. L. still seems to have a positive outlook on his life. Mr. L. is in Erikson's stage of generativity versus stagnation. I feel that he is in the generativity part of this stage. Generativity is where the person is able to assist the younger generation in developing and leading useful lives.

He is doing this by giving back to his family and being their for them and trying to go on in his normal routine. Pathophysiology Acute Myelogenous Leukemia (AML) AML results from acquired (not inherited) genetic damage to the DNA of developing cells in the bone marrow. The effects are: 1) the uncontrolled, exaggerated growth and accumulation of cells called "leukemic blasts" which fail to function as normal blood cells and 2) the blockade of the production of normal marrow cells, leading to a deficiency of red cells (anemia), and platelets (thrombocytopenia) and normal white cells (especially neutrophils, i. e., neutropenia) in the blood. Causes and Risk Factors Older people are more likely to develop the disease.

AML incidence increases dramatically among people who are over the age of 40. They are most prevalent in the sixth, seventh and eighth decades of life. Subtypes of Acute Myelogenous Leukemia Leukemia is a malignant disease (cancer) of the bone marrow and blood. AML can occur in a variety of ways; different types of cells may be seen by the physician in blood or marrow.

Since most patients have one of seven different patterns of blood cell involvement, these patterns have formed a subclassification. Myeloblasts are undeveloped cells. If they are the dominant leukemic cells in the marrow at the time of diagnosis the leukemia is referred to as "myeloblastic" type. If there are many myeloblasts but there are some cells developing towards fully formed blood cells, the added designation "with maturation" is used. If there are cells that are developing features of monocytes ("monocytic" type) or red cells ("erythroleukemic"), these designations are used and so forth. Even though the leukemia cells look somewhat like blood cells, the process of their formation is incomplete.

The subclassification of the disease is important. Different types of therapy may be used and the likely course of the disease may be different. Additional features may be important in guiding the choice of therapy, including: abnormalities of chromosomes, the cell immuno phenotype, the age and the general health of the patient, and others. FAB-M 1 normal cytogenetics FAB-M 1-Myeloblastic leukemia without maturation Normal Cytogenetics- Cytogenetics, by definition, is the study of the structure and the function of chromosomes. Lab Values (abnormal) WBC: 1.20 (4.0-10.8) The white blood cell (WBC) count indicates the number of white blood cells in a sample of blood.

This count provides a clue to the presence of illness. White blood cells are made in the bone marrow and protect the body against infection and aid in the immune response. If an infection develops, white blood cells attack and destroy the bacteria, fungus, or virus causing the infection. RBC: 2.36 (4.5-6.1) This test counts the number of red blood cells (RBC) in a liter of blood.

Red blood cells, which are made in the bone marrow, carry oxygen from the lungs to the cells and transport carbon dioxide from the cells to the lungs. HUB: 7.6 (14.0-17.0) This test measures the amount of hemoglobin (a protein found in red blood cells) in your blood and is a good indication of your blood's ability to carry oxygen throughout your body. HCT: 21.8 (42-52) Hematocrit is a measurement of the proportion of blood that is made up of red blood cells. PLT CNT: 22 (130-400) Patients who have a bone marrow disease, such as leukemia or other cancer in the bone marrow, often experience excessive bleeding, which is generally due to a significantly decreased number of platelets (thrombocytopenia). If platelet levels fall below 20,000 per micro liter, spontaneous bleeding may occur and is considered a risk. LYMPH 11 (20-40) Decreased lymphocyte levels can indicate diseases that affect the immune system or an infection.

A low result is indicating lymphocytopenia which could be caused by radiation therapy, sepsis, or immunodeficiency. EOSIN 6 (0-5) A high result is indicating Eosinophilia, which could be a sign of an allergic reaction or a parasitic infection or an indicator of an inflammatory response. BAND 14 (1-5) can increase in response to bacterial infection or inflammatory disease. Severe elevations in neutrophils may be caused by various bone marrow malignancies, such as chronic myelogenous leukemia.

NEUT ABS 0.7 (2.4-7.56) ANC will often appear on the blood test report of a person receiving chemotherapy. It refers to the percentage of neutrophils (white blood cells that fight infection) and cells that will become neutrophils multiplied by the white blood count (WBC). MONO ABS 0.0 (0.05-0.60) Decreased monocyte levels can indicate bone marrow injury or failure and some forms of leukemia..