ccIV.

PATHOPHYSIOLOGY: ACUTE LYMPHOCYTIC LEUKEMIA (BOOK-BASED):

c

c
Bacterial/ viral infection during infancy Exposure to Benzene/Cancer
Therapy
c
Inc. bone marrow activity
c
Activity synergistically with virus
c
d/t young age, bone marrow didn·t
recover
c
Changes in growth-regulating
c proteins without producing
Activation of viral oncogene that is
genetic changes
c essentially identical to cellular
oncogene
c

c
Entry into cell of oncogenic RNA virus
with viron oncogene
c Interfere with DNA synthesis in
normally dividing cells, particularly
c those in the bone marrow
DNA provirus produced in cell

c
Oncogenic mutation
c Insertion of DNA provirus into host
genome
c

c Activation of oncogene c

c
Bone depression
c

c Excess growth factors

c Abnormal growth

c
c
Radiation
c

c Formation of linkages between

pyramidine bases on the DNA
c molecules

c Altered DNA molecule is rapidly

impaired
c
„erves as promoters for other
c carcinogens Failure of the DNA repair mechanism
to operate
c

c Oncogenic mutation

c
 c Genetic

c Acquired genetic damage to the

DNA of a single cell in the marrow
c

c
Activation of abnormal specific DNA
c sequences

c
Interfere with DNA synthesis in
c normally dividing cells, particularly
those in bone marrow
c

c Oncogenic mutation

c
cNeoplastic cellular proliferation
occurs in bone marrow
c

c Cancer cells grow as

disorganized, multilayered
c masses that pile-up on one
another
c

c Loss of contact inhibition

c
Further cell division
c

c Excessive cell proliferation

c

c
Neoplastic cells do not
c resemble the cell of origin

c
Undifferentiated neoplasm Congestion of the morrow
c result in the bone marrow
c
Malignant transformation of „ubperiosteal bone infiltration
c lymphoid system cells
c
Uncontrolled proliferation of „pread of blast cells to the
c
lymphoid stem cells surface of the bone and into
c joint from the marrow activity

Lymphoblasts fall to function as

c
normal cells Bone and joint pain
c

c Lymphoblasts build up and

crowd out healthy needs
c

c c

c
 c

c Lymphoblasts replace the

normal marrow elements
c

c Normal marrow elements

c Dec. production of normal

blood cells
c

c
Dec. RBCs
c

c Dec. blood flow

c
Reduced hgb concentration
c

c Tissue hypoperfusion

c
Tissue hypoxia
c

c
Muscle Ishemia Dec. peripheral Dec. cerebral tissue
c perfusion perfusion

c
Anerobic metabolism
Body Dizziness,
Pale skin ad
c
Malaise fainting, fatigue,
mucous
lethargy
c Lactic Production membrane; and
prolonged CRT
c

c Myalgia

c c

c
 c

c
Myocardial hypoxia Dec. perfusion of
c lung cells

c Anerobic
metabolism DOB Cyanosis
c

c
Lactic acid
production
c
Nasal flaring
c Use of accessory
Angina muscle in breathing
c

c Inc. RR
Inc.c stroke c
volume and
HR
 c

c
Dec. WBC

Dec. Dec. Dec. Dec.

basophil eosinophil neutrophil monocytes
count count count count

Not enough Inability to

heparin breakdown mast
production cells and basophils

Reduce
Impaired clot inflammatory
formation
response

Inc. risk of
bleeding Infection

Inc vascular Red bone marrow

permiability tries to produce
and release large
amt of WBCs but
Lost of large amt of fail
fluid from the blood
into the tissue
„epticemia

Dec. blood volume

„hock DEATH