Jenny Cote Case Studies
JENNY COSTE
This is the case of Jenny Coste, 9 years old and was diagnosed with Acute Lymphoblastic Leukemia. She complains pain in her legs and loss of appetite early July of 2013. She plays sports in her school and her family thought it might be the cause until she feels tired all the time and does not want to participate in school activities. Her symptoms become severe and decided to see the doctor. In early September of 2013, they visit their General Practitioner, Dr. Brown and she was observed to be very pale and has rapid respiration. Diagnostic tests and laboratories was ordered and finally diagnosed to have acute lymphoblastic leukaemia. She undergoes intensive chemotherapy and have been in and out of the hospital for 18 months. She …show more content…
The pre-medical history of Jenny having varicella when she was three years old may play a role in the development of the disease but still needs further investigation. Various laboratories and diagnostic tests will confirm and detect the prognosis of the patient, such as bone marrow biopsy and lumbar puncture. The essential diagnostic feature of acute leukemia is a hyper-cellular bone marrow with greater than 30% replacement of blast cells according to Nair and Pete (2013). Since ALL progresses rapidly, it needs treatment as soon as the disease is detected. The treatment will depend on the subtype of ALL, age and general health of the person and the genetic make-up of the leukemic cells (Nair & Pete …show more content…
The time required to eliminate the large leukemic-cell population to undetectable levels is the single most powerful prognostic factor in ALL in children. Jenny’s choice of treatment consists of a common backbone of chemotherapy, including vincristine, anthracyclines-doxorubin and prednisone. According to Rose-Ihnman and Kuehl (2014), the effectivity of this combination can target a remission in up to 90% of patients. However, Hunger and Mullighan (2015) believes that a survival rate of 10 to 20% of almost all children with relapsed occurs, commonly in the central nervous system. The vincristine mechanism of action is not precise, but appears to “bind to crystallise critical microtubular proteins of the mitotic spindle, thus preventing their proper polymerization and causing metaphase arrest” therefore blocking the cell division. On the other hand, doxorubicin acts as an interference to “DNA-dependent RNA synthesis”. It distorts DNA leading to cell apoptosis. The use of dexamethasone versus prednisone varies among groups of patients because each of these glucocorticoids has pros and cons. Dexamethasone is associated with greater untoward side effects than prednisolone. Although, dexamethasone exhibits more activity since it can penetrate blood brain barrier, it can also cause greater adverse effect (Inaba & Pui 2010). In studies of Inaba and Pui (2010), there is no difference
This is the case of Jenny Coste, 9 years old and was diagnosed with Acute Lymphoblastic Leukemia. She complains pain in her legs and loss of appetite early July of 2013. She plays sports in her school and her family thought it might be the cause until she feels tired all the time and does not want to participate in school activities. Her symptoms become severe and decided to see the doctor. In early September of 2013, they visit their General Practitioner, Dr. Brown and she was observed to be very pale and has rapid respiration. Diagnostic tests and laboratories was ordered and finally diagnosed to have acute lymphoblastic leukaemia. She undergoes intensive chemotherapy and have been in and out of the hospital for 18 months. She …show more content…
The pre-medical history of Jenny having varicella when she was three years old may play a role in the development of the disease but still needs further investigation. Various laboratories and diagnostic tests will confirm and detect the prognosis of the patient, such as bone marrow biopsy and lumbar puncture. The essential diagnostic feature of acute leukemia is a hyper-cellular bone marrow with greater than 30% replacement of blast cells according to Nair and Pete (2013). Since ALL progresses rapidly, it needs treatment as soon as the disease is detected. The treatment will depend on the subtype of ALL, age and general health of the person and the genetic make-up of the leukemic cells (Nair & Pete …show more content…
The time required to eliminate the large leukemic-cell population to undetectable levels is the single most powerful prognostic factor in ALL in children. Jenny’s choice of treatment consists of a common backbone of chemotherapy, including vincristine, anthracyclines-doxorubin and prednisone. According to Rose-Ihnman and Kuehl (2014), the effectivity of this combination can target a remission in up to 90% of patients. However, Hunger and Mullighan (2015) believes that a survival rate of 10 to 20% of almost all children with relapsed occurs, commonly in the central nervous system. The vincristine mechanism of action is not precise, but appears to “bind to crystallise critical microtubular proteins of the mitotic spindle, thus preventing their proper polymerization and causing metaphase arrest” therefore blocking the cell division. On the other hand, doxorubicin acts as an interference to “DNA-dependent RNA synthesis”. It distorts DNA leading to cell apoptosis. The use of dexamethasone versus prednisone varies among groups of patients because each of these glucocorticoids has pros and cons. Dexamethasone is associated with greater untoward side effects than prednisolone. Although, dexamethasone exhibits more activity since it can penetrate blood brain barrier, it can also cause greater adverse effect (Inaba & Pui 2010). In studies of Inaba and Pui (2010), there is no difference