Question

A 68-year-old woman with acute myelogenous leukemia (AML) asks the nurse whether the planned chemotherapy will be worth undergoing. Which response by the nurse is appropriate?

a. "If you do not want to have chemotherapy, other treatment options include stem cell transplantation."
b. "The side effects of chemotherapy are difficult, but AML frequently goes into remission with chemotherapy."
c. "The decision about treatment is one that you and the doctor need to make rather than asking what I would do."
d. "You don't need to make a decision about treatment right now because leukemias in adults tend to progress quite slowly."

Answer 1

In acute myelogenous leukemia, the impaired production of erythrocytes occurs due to the overproduction of immature white blood cells. A patient with an absolute neutrophil count above 1500 cells per microliter would generally be cleared for continuing chemotherapy. Stem cell transplantation, including bone marrow transplants, is used to treat and potentially cure leukemia.

Step-by-step explanation:

A patient with acute myelogenous leukemia (AML) would indeed experience impaired production of erythrocytes, as AML primarily affects the myeloid line of cells which includes erythrocytes, platelets, and various types of leukocytes. Consequently, the production of all these cells can be affected. AML is characterized by an overproduction of immature white blood cells that do not function properly, which crowds out the production of other necessary cells.

Regarding the adverse effects of cancer chemotherapy, one of the most common is the destruction of leukocytes, particularly neutrophils. An absolute neutrophil count (ANC) test is conducted before a patient undergoes chemotherapy to ensure their neutrophil counts are not too low which would greatly increase the risk of infection. With a neutrophil count of 1900 cells per microliter, this level is generally considered safe to proceed with chemotherapy, as counts below 1500 cells per microliter are often regarded as a threshold for increased infection risk.

Stem cell transplantation, which includes bone marrow transplants, can be a viable treatment option to replace abnormal marrow with healthy marrow, demonstrating potential for curing conditions like leukemia. Prior to transplantation, finding a compatible match is crucial to increase the likelihood of success and minimize the risk of complications such as graft-versus-host disease.