Understanding of adult acute leukemia
Foreword
Leukemia is a variety of human malignancies, the most rapid development of the disease, treatment of the most complex person. Meanwhile, with scientific progress, the treatment of leukemia is rapidly improving. Leukemia patients, family belong to the time of morbidity, psychological, physical, will inevitably be a great impact, but because of the menacing disease, patients and family members did not for a long time can be adapted to the disease. Hospital Cancer Center team of malignant disease of hematopoietic function, especially in sub-health education for this edit this information, I hope to help patients and their families, to understand this disease, and peace of mind to accept treatment.
Situation in Taiwan
Acute myeloid leukemia incidence in Taiwan every year for about 3-5 people per 100,000 population, annual mortality rate of about 2-4 people per 100,000 population. In other words, Taiwan every year about 600 to 1,000 newly diagnosed patients, the incidence of Europe and the United States as well as or slightly lower, mostly adult patients. Acute lymphoblastic leukemia incidence is low, more children than in adults, but the incidence of the elderly is another wave heights. According to information released by the Department of Health, the total number of deaths of leukemia cancer deaths 2.61%; mortality ranking eighth male and female tenth. According to National Taiwan University School of Public Health Statistics found that the annual loss caused by people's health (ie reducing life expectancy than the average number of years) most cancer is leukemia, while the cost of treatment of leukemia cancer ranks first in average a person suffering from a lifetime consumption medical costs, more than 2.4 million yuan, which also shows the treatment of leukemia, is particularly complex and expensive than other diseases. Fortunately, the national health insurance already included in the acute and chronic leukemia covered for major injuries, the patient need not be borne part of the medical expenses.
Foreword
Leukemia is a variety of human malignancies, the most rapid development of the disease, treatment of the most complex person. Meanwhile, with scientific progress, the treatment of leukemia is rapidly improving. Leukemia patients, family belong to the time of morbidity, psychological, physical, will inevitably be a great impact, but because of the menacing disease, patients and family members did not for a long time can be adapted to the disease. Hospital Cancer Center team of malignant disease of hematopoietic function, especially in sub-health education for this edit this information, I hope to help patients and their families, to understand this disease, and peace of mind to accept treatment.
Situation in Taiwan
Acute myeloid leukemia incidence in Taiwan every year for about 3-5 people per 100,000 population, annual mortality rate of about 2-4 people per 100,000 population. In other words, Taiwan every year about 600 to 1,000 newly diagnosed patients, the incidence of Europe and the United States as well as or slightly lower, mostly adult patients. Acute lymphoblastic leukemia incidence is low, more children than in adults, but the incidence of the elderly is another wave heights. According to information released by the Department of Health, the total number of deaths of leukemia cancer deaths 2.61%; mortality ranking eighth male and female tenth. According to National Taiwan University School of Public Health Statistics found that the annual loss caused by people's health (ie reducing life expectancy than the average number of years) most cancer is leukemia, while the cost of treatment of leukemia cancer ranks first in average a person suffering from a lifetime consumption medical costs, more than 2.4 million yuan, which also shows the treatment of leukemia, is particularly complex and expensive than other diseases. Fortunately, the national health insurance already included in the acute and chronic leukemia covered for major injuries, the patient need not be borne part of the medical expenses.
Acute leukemia
I. Introduction
Acute leukemia is a malignant blood diseases and blood-forming organs, according to the Department of Health statistics, the total number of deaths of leukemia cancer deaths of 2.61%; mortality ranking eighth male and female tenth. In recent years, with chemical treatment and supportive therapy (such as antibiotics, blood transfusions, antiemetic or analgesic therapy, etc.) have a significant progress. Medical advances have been effective in the treatment of patients with leukemia and to maintain a good quality of life.
I. Introduction
Acute leukemia is a malignant blood diseases and blood-forming organs, according to the Department of Health statistics, the total number of deaths of leukemia cancer deaths of 2.61%; mortality ranking eighth male and female tenth. In recent years, with chemical treatment and supportive therapy (such as antibiotics, blood transfusions, antiemetic or analgesic therapy, etc.) have a significant progress. Medical advances have been effective in the treatment of patients with leukemia and to maintain a good quality of life.
II. what is acute leukemia (Acute Leukemia)?
Leukemia generally also called leukemia, is derived from the bone marrow of a malignant disease. Often the bone marrow hyperplasia abnormal white blood cells, white blood cell count in the blood may increase, decrease, or even normal. Bone marrow hematopoietic function is suppressed, often anemia, platelet deficiency situation. Leukemia, including acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML or ANLL), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Course of the development of acute leukemia in which more rapid, more blood is immature leukemia cells (also known as bud cells), shall be treated in the shortest time possible. Relatively high incidence of AML ALL. The older, the incidence is higher, the real cause of the disease has not yet been understood.
AML is an annual incidence of about 2.3 per 100,000 people, slightly more men than women, and older the chance is higher. In recent years, the incidence has not changed much.
Leukemia generally also called leukemia, is derived from the bone marrow of a malignant disease. Often the bone marrow hyperplasia abnormal white blood cells, white blood cell count in the blood may increase, decrease, or even normal. Bone marrow hematopoietic function is suppressed, often anemia, platelet deficiency situation. Leukemia, including acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML or ANLL), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML). Course of the development of acute leukemia in which more rapid, more blood is immature leukemia cells (also known as bud cells), shall be treated in the shortest time possible. Relatively high incidence of AML ALL. The older, the incidence is higher, the real cause of the disease has not yet been understood.
AML is an annual incidence of about 2.3 per 100,000 people, slightly more men than women, and older the chance is higher. In recent years, the incidence has not changed much.
III. the symptoms of leukemia
Initial symptoms may be loss of appetite, fatigue, fever, often bruising or bleeding phenomenon. Since then the gradual emergence of the following types of symptoms:
A loss of appetite, tiredness, weight loss, weight loss gradually.
(2) fever, sweating: due to abnormal proliferation of white blood cells, releasing pyrogenic substances, or because of normal leukopenia, and therefore prone to cause infection.
3 Anemia: Because red blood cells decreased hemoglobin decreased.
4 bone or joint pain: the main cause of blood cells within the bone marrow hyperplasia of the rules.
5 Skin bruising or bleeding, thrombocytopenia because of it.
6 color yellow: because of anemia, therefore, a small number of patients with obstructive jaundice.
7 nosebleeds, mouth bleeding, and occasionally have black stools or urine.
8 lymph nodes, but most will not feel pain or tenderness, usually occurs in the neck, armpit or groin.
9 hepatosplenomegaly, abdominal distension, abdominal pain.
10 testicular enlargement: a small number of cancer cells invade blood of patients with testicular rules.
11 swollen tonsils, mouth, trachea due to peripheral lymphoid tissue swelling and affect breathing
12 increased intracranial pressure caused by headache, vomiting, etc.: a small number of patients due to blood cells invade the central nervous, but few patients because of low platelets intracranial hemorrhage.
Initial symptoms may be loss of appetite, fatigue, fever, often bruising or bleeding phenomenon. Since then the gradual emergence of the following types of symptoms:
A loss of appetite, tiredness, weight loss, weight loss gradually.
(2) fever, sweating: due to abnormal proliferation of white blood cells, releasing pyrogenic substances, or because of normal leukopenia, and therefore prone to cause infection.
3 Anemia: Because red blood cells decreased hemoglobin decreased.
4 bone or joint pain: the main cause of blood cells within the bone marrow hyperplasia of the rules.
5 Skin bruising or bleeding, thrombocytopenia because of it.
6 color yellow: because of anemia, therefore, a small number of patients with obstructive jaundice.
7 nosebleeds, mouth bleeding, and occasionally have black stools or urine.
8 lymph nodes, but most will not feel pain or tenderness, usually occurs in the neck, armpit or groin.
9 hepatosplenomegaly, abdominal distension, abdominal pain.
10 testicular enlargement: a small number of cancer cells invade blood of patients with testicular rules.
11 swollen tonsils, mouth, trachea due to peripheral lymphoid tissue swelling and affect breathing
12 increased intracranial pressure caused by headache, vomiting, etc.: a small number of patients due to blood cells invade the central nervous, but few patients because of low platelets intracranial hemorrhage.
VI. the diagnosis of leukemia
The diagnosis of leukemia, initially by medical history, blood tests (CBC) and blood smears. If the results of the check suspicious, you must make further bone marrow examination.
The symptoms of leukemia at the beginning, may be associated with symptoms similar to flu, fever, fatigue, pallor, etc.; And the incidence of leukemia cells in the bud early, will not necessarily appear in the blood, bone marrow and in fact already exist, so the bone marrow in the diagnosis of leukemia is necessary, and classified according to their cells in order to determine the type of leukemia, the development of an appropriate treatment plan.
A bone marrow examination:
Is a simple and safe procedure, general adult sternum by the chest, as if to be added slices, from the back hip (waist) near iliac spine position after sampling; first under the skin and subcutaneous periosteum for small-scale local anesthesia, and then inserted into the marrow cavity of the bone marrow biopsy needle, draw out a small amount of bone marrow tissue for examination. Check the items, except under a microscope to make morphological classification, staining, cellular immunity pattern analysis and chromosomal, genetic testing is necessary items.
2 spinal fluid examination:
In ALL of the necessary checks, AML is depending on condition may be. Its purpose there are two, one for doing cytology specimens collected, if found to have bud cells exist, proved to be a violation of the central nervous system leukemia. The other is the amount of chemical drugs injected into the central nervous system (this treatment is called intrathecal chemotherapy, commonly known as IT); This is the prevention of central nervous system leukemia, or the treatment of central nervous system leukemia. This examination and treatment usually can be completed within 30 minutes, the process is to insert the needle into the lumbar spine between the two, so that fluid flow amount of inspection, and then injected into the same volume of diluted chemical drugs. Examination and treatment, the need to maintain a flat tummy half hour before or two hours before lying down at least six hours completed.
Various checks described above are a necessary process of leukemia diagnosis, the physician, to elaborate treatment plan, and in the course of treatment detect whether there is evidence of recurrence.
The diagnosis of leukemia, initially by medical history, blood tests (CBC) and blood smears. If the results of the check suspicious, you must make further bone marrow examination.
The symptoms of leukemia at the beginning, may be associated with symptoms similar to flu, fever, fatigue, pallor, etc.; And the incidence of leukemia cells in the bud early, will not necessarily appear in the blood, bone marrow and in fact already exist, so the bone marrow in the diagnosis of leukemia is necessary, and classified according to their cells in order to determine the type of leukemia, the development of an appropriate treatment plan.
A bone marrow examination:
Is a simple and safe procedure, general adult sternum by the chest, as if to be added slices, from the back hip (waist) near iliac spine position after sampling; first under the skin and subcutaneous periosteum for small-scale local anesthesia, and then inserted into the marrow cavity of the bone marrow biopsy needle, draw out a small amount of bone marrow tissue for examination. Check the items, except under a microscope to make morphological classification, staining, cellular immunity pattern analysis and chromosomal, genetic testing is necessary items.
2 spinal fluid examination:
In ALL of the necessary checks, AML is depending on condition may be. Its purpose there are two, one for doing cytology specimens collected, if found to have bud cells exist, proved to be a violation of the central nervous system leukemia. The other is the amount of chemical drugs injected into the central nervous system (this treatment is called intrathecal chemotherapy, commonly known as IT); This is the prevention of central nervous system leukemia, or the treatment of central nervous system leukemia. This examination and treatment usually can be completed within 30 minutes, the process is to insert the needle into the lumbar spine between the two, so that fluid flow amount of inspection, and then injected into the same volume of diluted chemical drugs. Examination and treatment, the need to maintain a flat tummy half hour before or two hours before lying down at least six hours completed.
Various checks described above are a necessary process of leukemia diagnosis, the physician, to elaborate treatment plan, and in the course of treatment detect whether there is evidence of recurrence.
V. how to treat
1 Chemical treatment:
Leukemia chemotherapy administered anticancer drug target in order to destroy cancer cells until bone marrow remission, and then continued on a regular basis giving drugs to kill remaining cancer cells until healed. Experts in accordance with the condition of the indicators and prognostic factors of different intensities proposed treatment plan
The chemical treatment of AML remission induction period, a period of consolidation. Some patients still plus maintenance phase. The purpose of inducing remission of the disease into complete remission stage, usually in Ara-C in conjunction with other drugs. After the bone marrow examination should be made to confirm the complete remission and subsequently every three or four weeks to a consolidation chemotherapy. Consolidation treatment frequency is at least four times, according to personal physical condition may be, the condition or prognosis factor which is slightly different. Different types of leukemia may have different chemical treatments. Physician after the intended treatment plan, will explain the treatment methods and to introduce therapeutic content.
1 Chemical treatment:
Leukemia chemotherapy administered anticancer drug target in order to destroy cancer cells until bone marrow remission, and then continued on a regular basis giving drugs to kill remaining cancer cells until healed. Experts in accordance with the condition of the indicators and prognostic factors of different intensities proposed treatment plan
The chemical treatment of AML remission induction period, a period of consolidation. Some patients still plus maintenance phase. The purpose of inducing remission of the disease into complete remission stage, usually in Ara-C in conjunction with other drugs. After the bone marrow examination should be made to confirm the complete remission and subsequently every three or four weeks to a consolidation chemotherapy. Consolidation treatment frequency is at least four times, according to personal physical condition may be, the condition or prognosis factor which is slightly different. Different types of leukemia may have different chemical treatments. Physician after the intended treatment plan, will explain the treatment methods and to introduce therapeutic content.
ALL chemotherapy can be divided into the following five stages:
a. guide remission: Let the bone marrow of patients achieved remission state. Initially starting treatment four or five weeks, the bone marrow to restore normal function to guide, to alleviate the condition. After treatment is completed at this stage within the bone marrow cells of blood around the rest of the original one percent or less, with a microscope counting, bud cells of all nucleated cells of five percent or less.
b. consolidation treatment period: This period of replacement drugs, to eliminate residual cancer cells, so that the rest of the blood cells of less than one ten thousandth of the ideal number of extent.
c. maintenance therapy period: given daily medication, journey takes two to three years.
d. strengthen the treatment period: Regular given to strengthen the treatment.
e. central nervous system prophylaxis: Because the general chemical drugs can not enter the central nervous system, so the need for intrathecal injection, the anti-cancer drugs follow the spinal fluid circulation up to protect the meninges, or hidden in the central nervous system to eliminate cancer cells .
(2) Supportive therapy:
Since the disease itself and the effects of chemical drugs, patients often suffered from anemia, bleeding or bacterial, fungal or viral infections and other symptoms. In response to these symptoms generally supportive therapy such as the following:
a. transfusions of red blood cells to treat anemia.
b. platelet transfusions to treat bleeding.
c. use of antibiotics to treat the infection.
d. supply adequate nutrition patients.
e. prevent infection.
f. antiemetic.
g. pain treatment.
3 bone marrow transplantation:
For some chemical therapy, relapse or belonging to high-risk group of patients with acute lymphoblastic leukemia, bone marrow transplant is another glimmer of hope. Bone marrow transplant indications include various leukemias, but with acute myelogenous leukemia and chronic myelogenous leukemia is more common in disease remission and, if appropriate, from the donor, the implementation of a bone marrow transplant have a higher cure rate. But transplant is a high risk of treatment should be carefully selected patients and carefully assessed.
a. guide remission: Let the bone marrow of patients achieved remission state. Initially starting treatment four or five weeks, the bone marrow to restore normal function to guide, to alleviate the condition. After treatment is completed at this stage within the bone marrow cells of blood around the rest of the original one percent or less, with a microscope counting, bud cells of all nucleated cells of five percent or less.
b. consolidation treatment period: This period of replacement drugs, to eliminate residual cancer cells, so that the rest of the blood cells of less than one ten thousandth of the ideal number of extent.
c. maintenance therapy period: given daily medication, journey takes two to three years.
d. strengthen the treatment period: Regular given to strengthen the treatment.
e. central nervous system prophylaxis: Because the general chemical drugs can not enter the central nervous system, so the need for intrathecal injection, the anti-cancer drugs follow the spinal fluid circulation up to protect the meninges, or hidden in the central nervous system to eliminate cancer cells .
(2) Supportive therapy:
Since the disease itself and the effects of chemical drugs, patients often suffered from anemia, bleeding or bacterial, fungal or viral infections and other symptoms. In response to these symptoms generally supportive therapy such as the following:
a. transfusions of red blood cells to treat anemia.
b. platelet transfusions to treat bleeding.
c. use of antibiotics to treat the infection.
d. supply adequate nutrition patients.
e. prevent infection.
f. antiemetic.
g. pain treatment.
3 bone marrow transplantation:
For some chemical therapy, relapse or belonging to high-risk group of patients with acute lymphoblastic leukemia, bone marrow transplant is another glimmer of hope. Bone marrow transplant indications include various leukemias, but with acute myelogenous leukemia and chronic myelogenous leukemia is more common in disease remission and, if appropriate, from the donor, the implementation of a bone marrow transplant have a higher cure rate. But transplant is a high risk of treatment should be carefully selected patients and carefully assessed.
VI. artificial blood vessels
Introduction
Acute leukemia patients whose condition requires, often need blood, injection drip and medicines, blood transfusions, administration of antibiotics. If the patient's blood thinner hours long for chemical treatment of the skin may be black or hardened blood vessels, therefore, increases the difficulty of injection and the patient's pain, if the leakage is caused by careless chemicals, more likely to cause local blood vessels and surrounding tissue damage and necrosis. Installed artificial blood vessels, the nurse can place the graft drip or injection drugs, and, as the case may be blood transfusion, blood and other treatment, so as to reduce the incidence of complications.Artificial blood vessels (Port-A catheter) can be divided into spheres and tubes most part, the ball portion sizes like 10 coins, stethoscope looks like a general. Tube about 70 cm, physicians will install it in the skin (usually in the shoulder near the clavicle), the outside does not come out. It is a synthetic siliceous materials, can co-exist with human tissue, and special effects do not occur, so it is used in the clinical safety and practicality rather high, and will not affect their daily lives.
After the implementation of the National Health Insurance, the device does not require patient cost of artificial blood vessels borne.
When the treatment plan has ended, since the artificial blood vessel may be made of long-term coexistence with human tissue, even not need to use, leaving no danger for the human body or sequelae, as the case may be removed. If you do not use nor removed, in principle, should be back to the clinic every month graft rinse, rinse just a few minutes.
Only a very small number of patients will occur graft displacement situations, if found to have shifted the position of artificial blood vessels, or feel there is flip the disc case, you should seek medical care immediately. To avoid displacement device side graft limb without excessive activity such as 360-degree rotation of the activity and not a single hand over heavy items, as life in general you do not need too much restraint.Means artificial blood vessels mostly under local anesthesia, so the items need to be prepared before surgery is fairly simple, as long as you can complete the following items.1 prior written consent of anesthesia and surgical consent.(2) the morning of surgery first remove the body jewelry, eyeglasses, dentures, hairpins, etc., if other valuables temporarily handed over to his family kept.3 Take off underwear that will prepare nurses serving patients with anti-wear.After surgery the patient's wound will cover gauze, surrounded by traces of disinfectant and anesthetic efficacy will slowly disappear. Patients may feel a little pain in the wound, the day will be adhered to an X-ray device to determine whether the position of the artificial blood vessel in the correct position. Nurses in physician determine graft position is correct, will return the same day or next day surgery with a special curved needle rinse artificial blood vessels, has been identified functional. Smooth and flush with the return of blood to connect drip.
Acute leukemia patients whose condition requires, often need blood, injection drip and medicines, blood transfusions, administration of antibiotics. If the patient's blood thinner hours long for chemical treatment of the skin may be black or hardened blood vessels, therefore, increases the difficulty of injection and the patient's pain, if the leakage is caused by careless chemicals, more likely to cause local blood vessels and surrounding tissue damage and necrosis. Installed artificial blood vessels, the nurse can place the graft drip or injection drugs, and, as the case may be blood transfusion, blood and other treatment, so as to reduce the incidence of complications.Artificial blood vessels (Port-A catheter) can be divided into spheres and tubes most part, the ball portion sizes like 10 coins, stethoscope looks like a general. Tube about 70 cm, physicians will install it in the skin (usually in the shoulder near the clavicle), the outside does not come out. It is a synthetic siliceous materials, can co-exist with human tissue, and special effects do not occur, so it is used in the clinical safety and practicality rather high, and will not affect their daily lives.
After the implementation of the National Health Insurance, the device does not require patient cost of artificial blood vessels borne.
When the treatment plan has ended, since the artificial blood vessel may be made of long-term coexistence with human tissue, even not need to use, leaving no danger for the human body or sequelae, as the case may be removed. If you do not use nor removed, in principle, should be back to the clinic every month graft rinse, rinse just a few minutes.
Only a very small number of patients will occur graft displacement situations, if found to have shifted the position of artificial blood vessels, or feel there is flip the disc case, you should seek medical care immediately. To avoid displacement device side graft limb without excessive activity such as 360-degree rotation of the activity and not a single hand over heavy items, as life in general you do not need too much restraint.Means artificial blood vessels mostly under local anesthesia, so the items need to be prepared before surgery is fairly simple, as long as you can complete the following items.1 prior written consent of anesthesia and surgical consent.(2) the morning of surgery first remove the body jewelry, eyeglasses, dentures, hairpins, etc., if other valuables temporarily handed over to his family kept.3 Take off underwear that will prepare nurses serving patients with anti-wear.After surgery the patient's wound will cover gauze, surrounded by traces of disinfectant and anesthetic efficacy will slowly disappear. Patients may feel a little pain in the wound, the day will be adhered to an X-ray device to determine whether the position of the artificial blood vessel in the correct position. Nurses in physician determine graft position is correct, will return the same day or next day surgery with a special curved needle rinse artificial blood vessels, has been identified functional. Smooth and flush with the return of blood to connect drip.
VII. the introduction of leukemia commonly
used drugs
The main purpose drug name side effects of the route of administrationAsparaginase(Leunase) chemical medicine intramuscular nausea, vomiting, fever, urticaria, liver and pancreas dysfunction, pancreatitis, hyperglycemia, fibrinogen, thrombocytopenia, vascular thrombosis.Cyclophosphamide(Endoxan) chemical medicine oral, intravenous injection or drip nausea, vomiting, loss of appetite, hemorrhagic cystitis, bone marrow suppression, oral mucosa, the formation of secondary neoplasia, alopecia, skin and nails black.Cytarabine(Cyclocide, Ara-C) chemical medicine intramuscular, subcutaneous, or intravenous drip injection, intrathecal injection of nausea, vomiting, oral ulcers, diarrhea, bone marrow suppression, thrombophlebitis, fever, and rash.Epirubicin chemical drugs intravenously nausea, vomiting, cardiac toxicity, fever, ulcers, skin ulcers caused by inadvertent leakage necrosis.Idarubicin chemical drugs intravenously nausea, vomiting, mucosal ulcers, cardiac toxicity, skin ulcers caused by inadvertent leakage necrosis.Etoposide(Vp-16) chemical drugs intravenously injected nausea, vomiting, allergic reactions, liver and kidney toxicity, bone marrow suppression.Vincristine (Oncovin) chemical drugs intravenously constipation, hair loss, neurotoxicity, abdominal pain, urinary retention, nausea and vomiting.Methotrexate(MTX) chemical medicine oral, intramuscular, or intravenous drip injection, intrathecal injection of nausea, vomiting, bone marrow suppression, oral ulcers, liver toxicity, alopecia, urticaria, headache.
Methotrexate(MTX) chemical medicine oral, intramuscular, or intravenous drip injection, intrathecal injection of nausea, vomiting, bone marrow suppression, oral ulcers, liver toxicity, alopecia, urticaria, headache.Mitoxantron(Novantron) chemical drugs intravenously injected nausea, vomiting, bone marrow suppression, hair loss, poor appetite, allergies, diarrhea, tired tired, fever, catarrh.Mercaptopurine(6-MP) chemical medicine oral nausea, vomiting, bone marrow suppression, jaundice.Co-trimoxazol(Bactrim, Baktar) oral medication to prevent infection gastrointestinal discomfort, allergic symptoms, bone marrow suppression.Nystatin (mycostatin) oral drugs prevent mold nausea, vomiting, diarrhea and other gastrointestinal discomfort, allergic symptoms.Prednisolone/ Dexan oral chemotherapy medication obesity, moon face, hypertension, hyperglycemia, peptic ulcer, personality changes.Zofran antiemetic oral, intravenous injection or drip, headache, flushing or head or upper abdomen warm feeling, constipation.Novaban antiemetic oral, intravenous injection or drip headache, gastrointestinal discomfort.Kytril antiemetic oral, intravenous injection or drip, headache, gastrointestinal discomfortG-CSF granulocyte erythropoietin subcutaneous or intravenous injection pain, headache
The main purpose drug name side effects of the route of administrationAsparaginase(Leunase) chemical medicine intramuscular nausea, vomiting, fever, urticaria, liver and pancreas dysfunction, pancreatitis, hyperglycemia, fibrinogen, thrombocytopenia, vascular thrombosis.Cyclophosphamide(Endoxan) chemical medicine oral, intravenous injection or drip nausea, vomiting, loss of appetite, hemorrhagic cystitis, bone marrow suppression, oral mucosa, the formation of secondary neoplasia, alopecia, skin and nails black.Cytarabine(Cyclocide, Ara-C) chemical medicine intramuscular, subcutaneous, or intravenous drip injection, intrathecal injection of nausea, vomiting, oral ulcers, diarrhea, bone marrow suppression, thrombophlebitis, fever, and rash.Epirubicin chemical drugs intravenously nausea, vomiting, cardiac toxicity, fever, ulcers, skin ulcers caused by inadvertent leakage necrosis.Idarubicin chemical drugs intravenously nausea, vomiting, mucosal ulcers, cardiac toxicity, skin ulcers caused by inadvertent leakage necrosis.Etoposide(Vp-16) chemical drugs intravenously injected nausea, vomiting, allergic reactions, liver and kidney toxicity, bone marrow suppression.Vincristine (Oncovin) chemical drugs intravenously constipation, hair loss, neurotoxicity, abdominal pain, urinary retention, nausea and vomiting.Methotrexate(MTX) chemical medicine oral, intramuscular, or intravenous drip injection, intrathecal injection of nausea, vomiting, bone marrow suppression, oral ulcers, liver toxicity, alopecia, urticaria, headache.
Methotrexate(MTX) chemical medicine oral, intramuscular, or intravenous drip injection, intrathecal injection of nausea, vomiting, bone marrow suppression, oral ulcers, liver toxicity, alopecia, urticaria, headache.Mitoxantron(Novantron) chemical drugs intravenously injected nausea, vomiting, bone marrow suppression, hair loss, poor appetite, allergies, diarrhea, tired tired, fever, catarrh.Mercaptopurine(6-MP) chemical medicine oral nausea, vomiting, bone marrow suppression, jaundice.Co-trimoxazol(Bactrim, Baktar) oral medication to prevent infection gastrointestinal discomfort, allergic symptoms, bone marrow suppression.Nystatin (mycostatin) oral drugs prevent mold nausea, vomiting, diarrhea and other gastrointestinal discomfort, allergic symptoms.Prednisolone/ Dexan oral chemotherapy medication obesity, moon face, hypertension, hyperglycemia, peptic ulcer, personality changes.Zofran antiemetic oral, intravenous injection or drip, headache, flushing or head or upper abdomen warm feeling, constipation.Novaban antiemetic oral, intravenous injection or drip headache, gastrointestinal discomfort.Kytril antiemetic oral, intravenous injection or drip, headache, gastrointestinal discomfortG-CSF granulocyte erythropoietin subcutaneous or intravenous injection pain, headache
VIII. complications
Acute complications of leukemia, cancer drugs and their primary and chemical dissolution or disease itself, including leukocytosis combined with tumor resolve syndrome, loss of bone marrow function leading to infection and bleeding toxicity. If thus suppress bone marrow function, you cause the following complications:
1 thrombocytopenia.
2 anemia.
3 Neutral neutropenia and infection symptoms and fever.
4 Severe infection leads to bacteremia, shock.
Acute complications of leukemia, cancer drugs and their primary and chemical dissolution or disease itself, including leukocytosis combined with tumor resolve syndrome, loss of bone marrow function leading to infection and bleeding toxicity. If thus suppress bone marrow function, you cause the following complications:
1 thrombocytopenia.
2 anemia.
3 Neutral neutropenia and infection symptoms and fever.
4 Severe infection leads to bacteremia, shock.
IX. home care precautions
In the face of the difficult process of cancer, the patient received chemotherapy in addition to outside, need more attentive care their loved ones, the following nursing care for common sense, can help caregivers to patients proper care.
1 regular medication, can not be unauthorized withdrawal:a. When the patient is discharged, it will bring home oral medication home, caregivers should be aware of the way of taking these drugs and uses and side effects.b. according to physician instructions to take medication regularly, do not try to stop the medication, otherwise easily lead to serious consequences and disease recurrence.
(2) Prevention of infection:a. maintain good health habits, especially the kitchen, toilets should be kept clean.b. attention to skin protection against mosquito bites and injured.c. avoid public places, something must wear masks when they go out.d. Avoid contact with colds, infectious diseases.e. Avoid contact with chicken pox patients, especially those not infected with varicella vaccine or who, if found in or around the home environment has long chickenpox, patients need close to its isolation. Once infected with chickenpox patients require prompt medical treatment, or it may cause serious complications and even death.
3 to develop good health habits:a. develop immediately after eating for mouth clean (rinse or brush your teeth with baking soda water) to reduce food waste retention mouth, reduce bacteria and maintain the habit once each morning and evening brushing, brushing should use a soft bristle toothbrush.b. bath every day, and to observe the integrity of the body skin, with or without wounds, broken skin, bleeding, bruising, rash and abnormal situations.c. develop fixed bowel habits, the solution will gently wipe from front to back after the anus and be washed.d. avoid rectal temperature and the amount of anal suppository use, to prevent damage to the anal mucous membrane irritation.e. keep the perineum clean, easy to hide dirt boy's foreskin, need to be cleaned.
4. Prevent bleeding:a. proper use of air conditioning to keep the air humidity, in order to avoid too dry nasal passages. Not hand pick your nose in order to avoid nasal bleeding.b. attention to home security, children with games to avoid falling bruises, avoid uphill climb to avoid falls.c. nails trimmed regularly to avoid scratching the skin.d. skin if blood clots, do not peel, so that clots off on their own.e. wear appropriate clothing (avoid tight clothes and choose the right shoes).f. Do not walk barefoot on the ground.
5 Observe signs of bleeding:Detailed records of the following symptoms should occur and closely observe the changes, continuous improvement should not seek medical treatment immediately back to the clinic:
a. there were minor mucocutaneous bleeding or bruising.b. stool red or black (tar colors).c. urine red.d. vomit red or brown.e. platelets is low, if any, headache, vomiting, drowsiness and other phenomena, confusion may be as cerebral hemorrhage, need emergency hospital treatment.
6 hemorrhage treatment:a. gingival bleeding sites, direct pressure to the affected area with cotton until the bloodless so far.b. nose bleeding, bleeding side of the nose pressed while sitting, ice forehead, the body to lean forward, do not swallow nosebleed. If continued bleeding, hospital treatment as soon as possible.
7 Fever Treatment:a. 37 ℃ to 37.5 ℃ between, drink plenty of water and fruit juice reduce the cover.b. axillary temperature between 37.5 ℃ to 38 ℃, use ice pillow.c. 38 ℃ above use of antipyretics.d. If the particle balls than 1000/mm ³, axillary temperature over 37.5 ℃ within two or more than 6 hours, or axillary temperature above 38 ℃ more than one hour, 38.5 ℃ more than twice, 39 ℃ more than once, it shall return hospital for medical treatment.
8 principles of nutrition:a. normal diet can be.b. avoid eating lettuce, raw and sashimi.c. Avoid eating food stimulation (such as pepper, coffee, etc.).d. Choose peelable or can be peeled fruit.e. cooking attention to hygiene.f. low white blood cells do not eat dairy products containing raw mushrooms.
9 gastrointestinal aspects:a. finish chemotherapy after returning home, if persistent nausea, not eating, either back to the hospital for medical treatment, to prevent water and electrolyte imbalance.b. If diarrhea occurs, then the mining light diet, avoid eating soybeans, sweet potatoes and other gas-producing foods.c. observation diarrhea stool frequency, shape, color, nature, etc., if the diarrhea does not improve the situation continued, it shall return to hospital for medical treatment.d. If constipation should eat more vegetables and fruits, and enough water. If more than three days unsolved stool, according physician instructed to use stool softeners, but not free to use enema.
10 Taboo:a. Avoid using aspirin-containing analgesics and nonsteroidal anti-inflammatory drug (NSAID) of antipyretics.b. chemical treatment, to avoid vaccination vaccine.
11 case histories manual applications:Prepare a notebook to record the patient's date of each blood, white blood cells, hemoglobin, platelet and granulocyte changes, and home when anomalies. Can help caregivers understand the patient's blood status, if in the period of bone marrow suppression, patient resistance is weak, you should pay special attention to the prevention of infection, and pay attention to the patient's physiological changes.
The above information, hoping to increase the patients and their families on leukemia awareness, understanding more care knowledge, in order to provide better care to enjoy a good quality of life.
In the face of the difficult process of cancer, the patient received chemotherapy in addition to outside, need more attentive care their loved ones, the following nursing care for common sense, can help caregivers to patients proper care.
1 regular medication, can not be unauthorized withdrawal:a. When the patient is discharged, it will bring home oral medication home, caregivers should be aware of the way of taking these drugs and uses and side effects.b. according to physician instructions to take medication regularly, do not try to stop the medication, otherwise easily lead to serious consequences and disease recurrence.
(2) Prevention of infection:a. maintain good health habits, especially the kitchen, toilets should be kept clean.b. attention to skin protection against mosquito bites and injured.c. avoid public places, something must wear masks when they go out.d. Avoid contact with colds, infectious diseases.e. Avoid contact with chicken pox patients, especially those not infected with varicella vaccine or who, if found in or around the home environment has long chickenpox, patients need close to its isolation. Once infected with chickenpox patients require prompt medical treatment, or it may cause serious complications and even death.
3 to develop good health habits:a. develop immediately after eating for mouth clean (rinse or brush your teeth with baking soda water) to reduce food waste retention mouth, reduce bacteria and maintain the habit once each morning and evening brushing, brushing should use a soft bristle toothbrush.b. bath every day, and to observe the integrity of the body skin, with or without wounds, broken skin, bleeding, bruising, rash and abnormal situations.c. develop fixed bowel habits, the solution will gently wipe from front to back after the anus and be washed.d. avoid rectal temperature and the amount of anal suppository use, to prevent damage to the anal mucous membrane irritation.e. keep the perineum clean, easy to hide dirt boy's foreskin, need to be cleaned.
4. Prevent bleeding:a. proper use of air conditioning to keep the air humidity, in order to avoid too dry nasal passages. Not hand pick your nose in order to avoid nasal bleeding.b. attention to home security, children with games to avoid falling bruises, avoid uphill climb to avoid falls.c. nails trimmed regularly to avoid scratching the skin.d. skin if blood clots, do not peel, so that clots off on their own.e. wear appropriate clothing (avoid tight clothes and choose the right shoes).f. Do not walk barefoot on the ground.
5 Observe signs of bleeding:Detailed records of the following symptoms should occur and closely observe the changes, continuous improvement should not seek medical treatment immediately back to the clinic:
a. there were minor mucocutaneous bleeding or bruising.b. stool red or black (tar colors).c. urine red.d. vomit red or brown.e. platelets is low, if any, headache, vomiting, drowsiness and other phenomena, confusion may be as cerebral hemorrhage, need emergency hospital treatment.
6 hemorrhage treatment:a. gingival bleeding sites, direct pressure to the affected area with cotton until the bloodless so far.b. nose bleeding, bleeding side of the nose pressed while sitting, ice forehead, the body to lean forward, do not swallow nosebleed. If continued bleeding, hospital treatment as soon as possible.
7 Fever Treatment:a. 37 ℃ to 37.5 ℃ between, drink plenty of water and fruit juice reduce the cover.b. axillary temperature between 37.5 ℃ to 38 ℃, use ice pillow.c. 38 ℃ above use of antipyretics.d. If the particle balls than 1000/mm ³, axillary temperature over 37.5 ℃ within two or more than 6 hours, or axillary temperature above 38 ℃ more than one hour, 38.5 ℃ more than twice, 39 ℃ more than once, it shall return hospital for medical treatment.
8 principles of nutrition:a. normal diet can be.b. avoid eating lettuce, raw and sashimi.c. Avoid eating food stimulation (such as pepper, coffee, etc.).d. Choose peelable or can be peeled fruit.e. cooking attention to hygiene.f. low white blood cells do not eat dairy products containing raw mushrooms.
9 gastrointestinal aspects:a. finish chemotherapy after returning home, if persistent nausea, not eating, either back to the hospital for medical treatment, to prevent water and electrolyte imbalance.b. If diarrhea occurs, then the mining light diet, avoid eating soybeans, sweet potatoes and other gas-producing foods.c. observation diarrhea stool frequency, shape, color, nature, etc., if the diarrhea does not improve the situation continued, it shall return to hospital for medical treatment.d. If constipation should eat more vegetables and fruits, and enough water. If more than three days unsolved stool, according physician instructed to use stool softeners, but not free to use enema.
10 Taboo:a. Avoid using aspirin-containing analgesics and nonsteroidal anti-inflammatory drug (NSAID) of antipyretics.b. chemical treatment, to avoid vaccination vaccine.
11 case histories manual applications:Prepare a notebook to record the patient's date of each blood, white blood cells, hemoglobin, platelet and granulocyte changes, and home when anomalies. Can help caregivers understand the patient's blood status, if in the period of bone marrow suppression, patient resistance is weak, you should pay special attention to the prevention of infection, and pay attention to the patient's physiological changes.
The above information, hoping to increase the patients and their families on leukemia awareness, understanding more care knowledge, in order to provide better care to enjoy a good quality of life.
Fever treatment of leukemia
patientsFever
is the body's an adaptive response, is a precursor to the disease and warning,
is also a very sensitive and reliable indicators, the vast majority of leukemia
patients with fever due to infection, should actively identify the cause and
begin treatment as soon as possible.
First, what is a fever?
Normal body temperature:Rectal temperature: 36 ° - 38 ° COral temperature: 35.5 ° - 37.5 ° CAxillary temperature: 35 ° - 37 ° CEar thermometer: Refer to the label's instructions
Body temperature regulation center called the hypothalamus, under normal circumstances, the central set rectal temperature was 38 ° C, when the temperature exceeds the normal range (rectal temperature of 38 ° C) is called a fever.
Second, fever stages:
1 episode: also known as cold period, he can be gradual or sudden. When pyrogens stimulate the hypothalamic set point when the temperature will rise, because the original set point is lower, and therefore feel cold, then the body in addition to preserving the existing body heat things, trying to generate more heat. Heat production methods have increased muscle activity (shivering, chills) and the increase in cell metabolism, body heat preservation method is to induce peripheral vasoconstriction and stop sweating, these methods make the body temperature.
2 febrile period: This procedure will feel more comfortable, the skin becomes hot, and the temperature will rise. This process may continue for hours or days. At this point through drug treatment or infection control so that the temperature drops.
3 cooling period: this period due to disease remission or taking antipyretics, the hypothalamus detects the temperature is too high, then will feel hot even perspiration circumstances, this is the hypothalamus by vasodilation and sweat to lower body temperature, so that the temperature back to the original set point.
Third, causes fever causes:
Infection (bacteria, viruses, fungi), trauma (surgery, tissue necrosis), blood transfusion, drug (chemical drugs, antibiotics), and the tumor itself is the cause and so on.
1 fever symptoms:a. skin, fever, redness, dry heat or sweating may be.b. chills, goose bumps on the skin.c. temperature increase per 1 ° C, basal metabolic rate increased by 10 to 13%.d. temperature increase per 1 ° C, an increase of 10 per minute, pulse 15 times.e. tachypnea.f. loss of appetite, thirsty lips.g. fatigue, drowsiness, cramps.
2 fever occurred after chemotherapy:Since the role of chemotherapy is used to stop the rapid growth of cancer cells, so will the role of the body in any fast dividing cells, and bone marrow due to the presence of rapidly dividing normal cells, and the body manufacture white blood cells, red blood cells, platelets main site, it will be subject to the effects of anti-cancer drugs have side effects. Patients receiving chemotherapy may occur 7-14 days after the side effects of bone marrow suppression, bone marrow suppression expected to have a longer and higher risk of infection, the patient may need to wait for the blood phase to restore stability. If the patient is expected to recover faster, the consent of the physician home recuperating, still have to pay attention to fever, bone marrow suppression during treatment, and emergency medical procedures, in order to avoid serious consequences.
Fourth, home care
1. Prevent infection:White blood cells are produced by the bone marrow, he would protect the body against bacteria, so if the body leukopenia, will increase the chance of infection, and its home care to note the following:a. maintain good environmental hygiene at home, especially in kitchens and bathrooms, cleaning and maintenance.b. avoid public places, something needs Children with wear masks when they go out. Avoid cold, infectious disease exposure.c. Avoid long contact with chickenpox. Chicken pox need to return to hospital for further treatment.(2) a harbinger of infection:Although you have to take care of special care, but there are still likely to be infected, the following signs of infection:
a. temperature oral temperature exceeds 38 ℃.b. chills.c. severe cough, runny nose, or throat irritation.d. diarrhea, abdominal pain.e. urine burning sensation.If the above can be signs of infection immediately inform the nursing staff for assistance.
3 fever treatment:a. axillary temperature 37 ° -37.5 ° C: to drink plenty of water, reduce the cover.b. axillary temperature 37.5 ° C or more: use ice pillow.c. axillary temperature 38 ° C above: seek medical treatment.
The role of case managerLeukemia is a highly complex treatments, in addition to specialized physicians and nurses of care, but also need the trust of patients and their families with the whole-hearted support, case manager's role is to healthcare professionals and patients and their families and social workers of the bridge, they can assist in patients 'family health education, counseling patients actually treated in accordance with the planned schedule, on the other hand, can also help physicians understand patients' social and psychological side, press in accordance with the full Treatment plan implementation.Case management division is a medical professional, social psychology, public health interdisciplinary professionals, patients and their families is a mentor. Case management division of the timely intervention of the patient's disease, cognitive, psychological support has greatly helpful, patient and case manager can establish good communication, in order to successfully complete the treatment, to improve their prognosis.
The introduction of social resources oncology patientsAcute leukemia caused by psychological, physical, economic and social impact and great, need to fully understand the family support and care. Families and patients unable to fully load this impact, it needs the assistance of social resources.Patients less than eighteen years of age, the Republic of China Children's Cancer Foundation can provide the money to assist the medical, hospital social services can be commissioned on behalf of processing the application class. In addition, the Court Social Services Division also conducted for the case to understand, to assist patients in obtaining a variety of charitable organizations and social assistance units. Local governments are also social bureaus can provide information and resources to assist patients.Patients due to illness produces permanent, incurable injuries, according to their degree of disability application manual (but still under treatment or temporary can not judge, who must track of irregularities should be discussed with the specialist physician to physician determines basis).Patients in stable condition, employability, employment difficulties, to seek social welfare agencies to assist.Patients had acceded to the Convention, agriculture, labor, according to the relevant provisions thereof apply for benefits, such as patients or family members do not understand the application process can contact the unit inquiry or ask social service personnel.Patients with more severe illness, family caregivers difficulties can ask doctors to evaluate and calculate the Barthel Index, Barthel Index score of 30 or less, in line with provisions of the domicile or foreign caregivers may apply for assistance care.Patients family problems, such as child care, education, marital disharmony, etc., through the social service personnel to help, try to resolve. Zhang also has social, lifeline or Family Support Center can provide possible assistance.Patient adjustment difficulties arising due to illness, psychological distress and even depression, you should seek Zhang, the lifeline of the guidance and assistance, if necessary psychiatrist intervention with drug or mental health treatment.
EpilogueMedical advances have made the treatment of acute leukemia outcomes improved. Current health insurance policy for expensive cancer treatment and related payment requirements but also enhance the quality of treatment and the public's willingness to accept treatment.Acute leukemia treatment requires a medical team integration. Medical Center with various medical subspecialty cancer care team can do the correct pathological diagnosis, disease classification, treatment and make the right decisions. Social service, patient care friendship can be achieved by the exchange of experience, mutual learning and encouraging results, strengthen emotional adaptation management and supporters. More due consideration to the individual's needs, attention to safe medical doctor-patient relationship and the quality of medical services contributed to someone. To the best results, you need everyone (patients, their families, health care team, social) joint efforts can be reached.
First, what is a fever?
Normal body temperature:Rectal temperature: 36 ° - 38 ° COral temperature: 35.5 ° - 37.5 ° CAxillary temperature: 35 ° - 37 ° CEar thermometer: Refer to the label's instructions
Body temperature regulation center called the hypothalamus, under normal circumstances, the central set rectal temperature was 38 ° C, when the temperature exceeds the normal range (rectal temperature of 38 ° C) is called a fever.
Second, fever stages:
1 episode: also known as cold period, he can be gradual or sudden. When pyrogens stimulate the hypothalamic set point when the temperature will rise, because the original set point is lower, and therefore feel cold, then the body in addition to preserving the existing body heat things, trying to generate more heat. Heat production methods have increased muscle activity (shivering, chills) and the increase in cell metabolism, body heat preservation method is to induce peripheral vasoconstriction and stop sweating, these methods make the body temperature.
2 febrile period: This procedure will feel more comfortable, the skin becomes hot, and the temperature will rise. This process may continue for hours or days. At this point through drug treatment or infection control so that the temperature drops.
3 cooling period: this period due to disease remission or taking antipyretics, the hypothalamus detects the temperature is too high, then will feel hot even perspiration circumstances, this is the hypothalamus by vasodilation and sweat to lower body temperature, so that the temperature back to the original set point.
Third, causes fever causes:
Infection (bacteria, viruses, fungi), trauma (surgery, tissue necrosis), blood transfusion, drug (chemical drugs, antibiotics), and the tumor itself is the cause and so on.
1 fever symptoms:a. skin, fever, redness, dry heat or sweating may be.b. chills, goose bumps on the skin.c. temperature increase per 1 ° C, basal metabolic rate increased by 10 to 13%.d. temperature increase per 1 ° C, an increase of 10 per minute, pulse 15 times.e. tachypnea.f. loss of appetite, thirsty lips.g. fatigue, drowsiness, cramps.
2 fever occurred after chemotherapy:Since the role of chemotherapy is used to stop the rapid growth of cancer cells, so will the role of the body in any fast dividing cells, and bone marrow due to the presence of rapidly dividing normal cells, and the body manufacture white blood cells, red blood cells, platelets main site, it will be subject to the effects of anti-cancer drugs have side effects. Patients receiving chemotherapy may occur 7-14 days after the side effects of bone marrow suppression, bone marrow suppression expected to have a longer and higher risk of infection, the patient may need to wait for the blood phase to restore stability. If the patient is expected to recover faster, the consent of the physician home recuperating, still have to pay attention to fever, bone marrow suppression during treatment, and emergency medical procedures, in order to avoid serious consequences.
Fourth, home care
1. Prevent infection:White blood cells are produced by the bone marrow, he would protect the body against bacteria, so if the body leukopenia, will increase the chance of infection, and its home care to note the following:a. maintain good environmental hygiene at home, especially in kitchens and bathrooms, cleaning and maintenance.b. avoid public places, something needs Children with wear masks when they go out. Avoid cold, infectious disease exposure.c. Avoid long contact with chickenpox. Chicken pox need to return to hospital for further treatment.(2) a harbinger of infection:Although you have to take care of special care, but there are still likely to be infected, the following signs of infection:
a. temperature oral temperature exceeds 38 ℃.b. chills.c. severe cough, runny nose, or throat irritation.d. diarrhea, abdominal pain.e. urine burning sensation.If the above can be signs of infection immediately inform the nursing staff for assistance.
3 fever treatment:a. axillary temperature 37 ° -37.5 ° C: to drink plenty of water, reduce the cover.b. axillary temperature 37.5 ° C or more: use ice pillow.c. axillary temperature 38 ° C above: seek medical treatment.
The role of case managerLeukemia is a highly complex treatments, in addition to specialized physicians and nurses of care, but also need the trust of patients and their families with the whole-hearted support, case manager's role is to healthcare professionals and patients and their families and social workers of the bridge, they can assist in patients 'family health education, counseling patients actually treated in accordance with the planned schedule, on the other hand, can also help physicians understand patients' social and psychological side, press in accordance with the full Treatment plan implementation.Case management division is a medical professional, social psychology, public health interdisciplinary professionals, patients and their families is a mentor. Case management division of the timely intervention of the patient's disease, cognitive, psychological support has greatly helpful, patient and case manager can establish good communication, in order to successfully complete the treatment, to improve their prognosis.
The introduction of social resources oncology patientsAcute leukemia caused by psychological, physical, economic and social impact and great, need to fully understand the family support and care. Families and patients unable to fully load this impact, it needs the assistance of social resources.Patients less than eighteen years of age, the Republic of China Children's Cancer Foundation can provide the money to assist the medical, hospital social services can be commissioned on behalf of processing the application class. In addition, the Court Social Services Division also conducted for the case to understand, to assist patients in obtaining a variety of charitable organizations and social assistance units. Local governments are also social bureaus can provide information and resources to assist patients.Patients due to illness produces permanent, incurable injuries, according to their degree of disability application manual (but still under treatment or temporary can not judge, who must track of irregularities should be discussed with the specialist physician to physician determines basis).Patients in stable condition, employability, employment difficulties, to seek social welfare agencies to assist.Patients had acceded to the Convention, agriculture, labor, according to the relevant provisions thereof apply for benefits, such as patients or family members do not understand the application process can contact the unit inquiry or ask social service personnel.Patients with more severe illness, family caregivers difficulties can ask doctors to evaluate and calculate the Barthel Index, Barthel Index score of 30 or less, in line with provisions of the domicile or foreign caregivers may apply for assistance care.Patients family problems, such as child care, education, marital disharmony, etc., through the social service personnel to help, try to resolve. Zhang also has social, lifeline or Family Support Center can provide possible assistance.Patient adjustment difficulties arising due to illness, psychological distress and even depression, you should seek Zhang, the lifeline of the guidance and assistance, if necessary psychiatrist intervention with drug or mental health treatment.
EpilogueMedical advances have made the treatment of acute leukemia outcomes improved. Current health insurance policy for expensive cancer treatment and related payment requirements but also enhance the quality of treatment and the public's willingness to accept treatment.Acute leukemia treatment requires a medical team integration. Medical Center with various medical subspecialty cancer care team can do the correct pathological diagnosis, disease classification, treatment and make the right decisions. Social service, patient care friendship can be achieved by the exchange of experience, mutual learning and encouraging results, strengthen emotional adaptation management and supporters. More due consideration to the individual's needs, attention to safe medical doctor-patient relationship and the quality of medical services contributed to someone. To the best results, you need everyone (patients, their families, health care team, social) joint efforts can be reached.
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