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Group 5

PATIENTS DATA L.E.S.J.


2 years old March 1, 2011 Filipino Roman Catholic

The patient was left when she was 7 days old at the gate of DC Provincial house and later on transferred to Hospicio de San Jose.

MEDICAL HISTORY
Family History:
Unknown

Medical History:
(-) allergies (-) asthma (+) chicken pox (+) pneumonia

Personal/Social History:
Complete EPI except MMR

MEDICAL HISTORY
History of Present Illness:
February 2012 first admission of the patient due to presenting s/sx. Patient is a known case of Acute Lymphoblastic Leukemia since February 2012, presenting with pallor, hepatosplinomegaly and bluncytomosis, S/P Chemotherapy cycle a patient was well until Sept. 2012, Diagnosed to have a relapse April-May 2013 BMA

MEDICAL HISTORY
Review of System: (+)Weight Loss (-)Loss of appetite (-)Cough (-)Colds

ACUTE LYMPHOCYTIC LEUKEMIA


Is a fast growing cancer of type of white blood cells called lymphocytes. It is commonly found in the bone marrow that produce white blood cells. It usually affects children between 3 to 7 years old. When the number of unhealthy lymphocytes in the bone marrow are increased, few red blood cells and platelets are produced

ACUTE LYMPHOCYTIC LEUKEMIA

CAUSES

It occurs when the body produces large number of immature white blood cells Lymphocytes . The cancer cells quickly grow and replace normal cells in bone marrow.

SIGNS & SYMPTOMS


Feeling weak or tired
Fever Paleness Loss of appetite and weight loss Night sweats.

SIGNS & SYMPTOMS

RISK FACTORS
Risk Factors:
Environmental Lifestyle Inherited (Genetic) Others: Geographical Ethnicity and Gender Chemical exposure Cancer therapy Electromagnetic fields

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY

DIAGNOSTIC EXAMS
Hematology
Hematology Leukocyte Erthrocyte Hematocrit Result 2.08 3.29 29.10 Unit 10^9/l 10^12L REFERENCE 5.0-10.0 4.6-6.2 40.0-54.0

Thrombocyte
Neutrophils lymphocyte Monocyte Eosinophils Basophils

220
7.700 78.300 10.000 2.200 1.800

10^9L

150-450
50.00-70.00 20.0-40.0 0.0-7.0 0.00-5.000 0.000-1.000

DIAGNOSTIC EXAMS
Physical Exam Blood test BMA Cytogenetic Analysis Chest X-ray CT Scan Lumbar Puncture MRI Biopsy

Immunophenotyping

Reverse Transcription

DIAGNOSTIC EXAMS
Bone Marrow Aspiration with Flow Cytometry
Bone marrow aspiration removes a small amount of bone marrow fluid and cells through a needle put into a bone. The bone marrow fluid and cells are checked for problems with any of the blood cells made in the bone marrow. Cells can be checked for chromosome problems. Cultures can also be done to look for infection.

DIAGNOSTIC EXAMS
Bone Marrow Aspiration

DIAGNOSTIC EXAMS
BMA with Flow Cytometry
Flow cytometry is a technology that simultaneously measures and then analyzes multiple physical characteristics of single particles, usually cells, as they ow in a uid stream through a beam of light. The properties measured include a particles relative size, relative granularity or internal complexity, and relative uorescence intensity.

DIAGNOSTIC EXAMS
Flow Cytometry

DIAGNOSTIC EXAMS
Myeloid/lymphoid leukemia (MLL) gene rearrangements via FISH
are signs of a bad prognosis in childhood acute lymphoblastic leukemia (ALL).13 this gene has an important role in developmental regulation of gene expression in normal hematopoiesis. Conventional cytogenetic and FISH analysis are the first choices and are complementary to one another, but fluorescence in situ hybridization (FISH) is a more sensitive method for detecting chromosomal

DIAGNOSTIC EXAMS

MEDICATION
Prednisone Prolix 10mg/5ml at full stomach TID Vincristine 0.7mg SIVP to be given Parenteral: IVF TF D5.03 NACL 500cc X 41-42 gtts/mins

Raymundo, Mark Jay Solis, Ricca Jeniveve Sybico, Rachel Teodoro, Michelle Ann Torralba, Mary Ann Tulagan, John Martin Tulalian, Sharmaine Villa, Viveeka Nency Yangat, Lucille Yuarata, Rigie Mae

GROUP 5