Przewlekła białaczka szpikowa – Charakterystyka, pielęgnacja i opieka

Przewlekła białaczka szpikowa
Charakterystyka, pielęgnacja i opieka

Przewlekła białaczka szpikowa (CML) to nowotwór hematologiczny charakteryzujący się nadprodukcją granulocytów, związany z obecnością chromosomu Philadelphia i genem fuzyjnym BCR-ABL. Choroba przebiega w trzech fazach: przewlekłej (ponad 90% pacjentów, <5% mieloblastów), akceleracji (10-30% mieloblastów) oraz blastycznej (>30% mieloblastów). Kluczowym elementem terapii są inhibitory kinazy tyrozynowej (TKI), które umożliwiają kontrolę choroby i poprawę jakości życia. Opieka pielęgniarska obejmuje monitorowanie morfologii krwi, poziomu transkryptu BCR-ABL (PCR), ocenę ryzyka infekcji, krwawień oraz wsparcie psychospołeczne. Pielęgniarki odgrywają istotną rolę w edukacji pacjentów, zarządzaniu skutkami ubocznymi TKI (np. nudności, wypadanie włosów, ryzyko krwawień) oraz koordynacji multidyscyplinarnej opieki.

Wprowadzenie do opieki nad pacjentem z przewlekłą białaczką szpikową
Fazy CML i ich znaczenie w opiece pielęgniarskiej

Ocena i monitorowanie w opiece pielęgniarskiej nad pacjentem z CML

Diagnozy pielęgniarskie w opiece nad pacjentem z CML

Ryzyko infekcji
Ryzyko krwawienia
Zmęczenie
Zaburzony obraz ciała

Interwencje pielęgniarskie i planowanie opieki

Zarządzanie terapią lekową
Edukacja i wzmacnianie pozycji pacjenta

Opieka wspierająca i zarządzanie objawami

Zarządzanie skutkami ubocznymi leczenia
Wsparcie żywieniowe
Wsparcie psychospołeczne

Długoterminowa obserwacja i opieka nad pacjentem przeżywającym chorobę

Monitorowanie i nadzór
Remisja bez leczenia
Opieka paliatywna i końca życia

Rola wyspecjalizowanej opieki pielęgniarskiej w CML

Zarządzanie przypadkiem i koordynacja opieki
Zaawansowana praktyka pielęgniarska w CML

Innowacje w opiece pielęgniarskiej nad pacjentem z CML

Telemedycyna i zdalne monitorowanie
Modele opieki skoncentrowane na pacjencie

Multidyscyplinarne podejście do opieki nad pacjentem z CML

Współpraca z zespołem medycznym
Zaangażowanie pacjenta i rodziny

Podsumowanie

Kolejne rozdziały

Wprowadzenie do opieki nad pacjentem z przewlekłą białaczką szpikową

Przewlekła białaczka szpikowa (CML, Chronic Myeloid Leukemia) jest nowotworem krwi i szpiku kostnego, w którym dochodzi do nadprodukcji dojrzałych i niedojrzałych granulocytów. Choroba rozwija się powoli, szczególnie w fazie przewlekłej, i związana jest z obecnością chromosomu Philadelphia, który powstaje w wyniku translokacji między chromosomami 9 i 22, prowadząc do powstania genu fuzyjnego BCR-ABL¹². Leczenie CML przeszło znaczącą transformację wraz z wprowadzeniem inhibitorów kinazy tyrozynowej (TKI), które zmieniły tę potencjalnie śmiertelną chorobę w schorzenie przewlekłe, możliwe do kontrolowania przez długi czas³.

Opieka pielęgniarska nad pacjentami z CML odgrywa kluczową rolę w całościowym zarządzaniu chorobą, od momentu diagnozy po długoterminową obserwację i monitoring. Współczesne podejście do opieki nad pacjentem z CML opiera się na holistycznym, multidyscyplinarnym modelu, gdzie pielęgniarki pełnią funkcję łącznika między pacjentem a zespołem medycznym, wspierając pacjenta w procesie leczenia i samoopieki⁴⁵.

Fazy CML i ich znaczenie w opiece pielęgniarskiej

CML charakteryzuje się trzema fazami choroby, które mają istotne implikacje dla planowania opieki pielęgniarskiej:

Faza przewlekła – większość pacjentów (ponad 90%) diagnozowana jest w tej fazie; liczba krwinek pozostaje względnie stabilna, a odsetek komórek blastycznych w szpiku i krwi jest niski (5% lub mniej). Pacjenci zwykle nie odczuwają poważnych objawów choroby⁶.
Faza akceleracji – charakteryzuje się trudnościami w kontrolowaniu choroby, wzrostem liczby białych krwinek oraz obecnością 10-30% mieloblastów w szpiku kostnym lub krwi obwodowej⁷.
Faza blastyczna – najbardziej zaawansowana faza, przypominająca ostrą białaczkę, gdzie w szpiku lub krwi występuje ponad 30% mieloblastów⁸.

Znajomość fazy choroby ma kluczowe znaczenie dla personelu pielęgniarskiego, ponieważ wpływa na intensywność opieki, monitoring pacjenta oraz planowanie interwencji terapeutycznych. Pacjenci w fazie przewlekłej zazwyczaj wymagają mniej intensywnej opieki niż ci w fazie akceleracji czy blastycznej⁹¹⁰.

Ocena i monitorowanie w opiece pielęgniarskiej nad pacjentem z CML

Kompleksowa ocena pielęgniarska pacjenta z CML powinna być przeprowadzana przy użyciu zwalidowanych narzędzi, a diagnozy pielęgniarskie powinny być odnotowywane w dokumentacji pacjenta¹¹. Kluczowe elementy oceny pielęgniarskiej obejmują:

Monitorowanie morfologii krwi i rozmazów: obserwacja oznak zwiększonego ryzyka infekcji (neutropenia), anemii i małopłytkowości¹².
Ocena pod kątem objawów infekcji: gorączka, dreszcze i wszelkie nowe objawy powinny być natychmiast zgłaszane, ponieważ pacjenci z białaczką mają upośledzoną odporność¹³.
Ocena krwawienia: poszukiwanie wybroczyn, siniaków i krwawienia z dziąseł, szczególnie u pacjentów z małopłytkowością¹⁴.
Ocena psychospołeczna: określenie mechanizmów radzenia sobie pacjenta, systemu wsparcia i potrzeb wsparcia psychologicznego¹⁵.

Regularne monitorowanie odpowiedzi na leczenie jest niezbędne i obejmuje kontrolę markerów molekularnych, takich jak poziom transkryptu BCR-ABL mierzony za pomocą reakcji łańcuchowej polimerazy (PCR). Osiągnięcie głębokiej odpowiedzi molekularnej (DMR) jest celem terapeutycznym, a jej monitorowanie umożliwia wczesne wykrycie nawrotu choroby lub oporności na leczenie¹⁶¹⁷.

Diagnozy pielęgniarskie w opiece nad pacjentem z CML

Na podstawie dokładnej oceny stanu pacjenta, pielęgniarki formułują diagnozy pielęgniarskie specyficzne dla przewlekłej białaczki szpikowej. Najczęstsze diagnozy pielęgniarskie dla pacjentów z CML obejmują:

Ryzyko infekcji

Pacjenci z CML są narażeni na zwiększone ryzyko infekcji z powodu wpływu choroby na szpik kostny i układ odpornościowy oraz działania immunosupresyjnego stosowanych leków¹⁸¹⁹.

Interwencje pielęgniarskie:

Wdrożenie środków ostrożności w neutropenii, takich jak higiena rąk, ograniczenie odwiedzin i unikanie ekspozycji na czynniki zakaźne²⁰.
Edukacja pacjenta na temat znaczenia profilaktyki zakażeń i rozpoznawania objawów infekcji, takich jak gorączka²¹.
Monitorowanie objawów infekcji, w tym gorączki, dreszczy i potów²².
Zalecanie szczepień przeciwko grypie, pneumokokom i COVID-19²³.

Ryzyko krwawienia

Ryzyko krwawienia związane jest z małopłytkowością i supresją szpiku kostnego²⁴.

Interwencje pielęgniarskie:

Edukacja pacjenta na temat unikania czynności, które mogą prowadzić do urazów²⁵.
Zalecanie używania miękkich szczoteczek do zębów²⁶.
Informowanie o unikaniu leków dostępnych bez recepty, takich jak aspiryna, które mogą zwiększać ryzyko krwawienia²⁷.
Monitorowanie wybroczyn, siniaków i innych oznak krwawienia²⁸.

Zmęczenie

Zmęczenie związane z anemią i efektami chemioterapii jest częstym problemem u pacjentów z CML²⁹.

Interwencje pielęgniarskie:

Zapewnienie strategii oszczędzania energii, takich jak częste okresy odpoczynku³⁰.
Zalecanie małych, bogatych w składniki odżywcze posiłków³¹.
Planowanie aktywności w okresach większej energii³².
Monitorowanie poziomu energii i zgłaszanie znaczącego zmęczenia zespołowi medycznemu³³.

Zaburzony obraz ciała

Zaburzenia obrazu ciała związane z wypadaniem włosów, utratą wagi i bladością skóry w wyniku leczenia białaczki³⁴.

Interwencje pielęgniarskie:

Oferowanie usług doradczych i zachęcanie do uczestnictwa w grupach wsparcia dla osób z białaczką³⁵.
Pomoc pacjentom w radzeniu sobie z problemami związanymi z wizerunkiem ciała, w tym z zarządzaniem wypadaniem włosów³⁶.
Zapewnienie wsparcia emocjonalnego i psychologicznego³⁷.

Interwencje pielęgniarskie i planowanie opieki

Planowanie opieki pielęgniarskiej nad pacjentem z CML powinno obejmować kompleksowe interwencje ukierunkowane na konkretne problemy zdrowotne i potrzeby pacjenta. Cele i oczekiwane wyniki mogą obejmować:

Pacjent zidentyfikuje działania zapobiegające/zmniejszające ryzyko infekcji³⁸.
Pacjent będzie demonstrował techniki i zmiany stylu życia promujące bezpieczne środowisko i osiągnięcie szybkiego gojenia³⁹.
Pacjent pozostanie wolny od powikłań związanych z infekcją i krwawieniem⁴⁰.
Zmęczenie będzie skutecznie zarządzane poprzez odpowiednie interwencje⁴¹.
Pacjent wykaże zrozumienie białaczki i jej leczenia, w tym potencjalnych skutków ubocznych⁴².
Pacjent rozwinie strategie radzenia sobie z emocjonalnymi i fizycznymi wyzwaniami związanymi z białaczką⁴³.

Zarządzanie terapią lekową

Głównym leczeniem CML są inhibitory kinazy tyrozynowej (TKI), które blokują białko wytwarzane przez gen BCR-ABL, odpowiedzialne za niekontrolowane namnażanie białych krwinek⁴⁴. Pielęgniarki odgrywają kluczową rolę w zarządzaniu terapią TKI poprzez:

Edukację pacjenta na temat znaczenia ścisłego przestrzegania zaleceń dotyczących przyjmowania leków⁴⁵.
Monitorowanie skutków ubocznych leczenia, które mogą wpływać na przestrzeganie zaleceń⁴⁶.
Współpracę z zespołem medycznym w celu dostosowania dawki leku w przypadku wystąpienia działań niepożądanych⁴⁷.
Informowanie pacjenta o potencjalnych interakcjach leków z innymi lekami, suplementami i żywnością⁴⁸.

Ważne jest, aby pielęgniarki podkreślały znaczenie regularnych badań kontrolnych w celu monitorowania odpowiedzi na leczenie i wczesnego wykrywania potencjalnych problemów⁴⁹.

Edukacja i wzmacnianie pozycji pacjenta

Edukacja pacjenta jest kluczowym elementem opieki pielęgniarskiej nad osobami z CML. Pielęgniarki mogą wspierać wzmocnienie pozycji pacjenta poprzez:

Dostarczanie informacji o chorobie, leczeniu i potencjalnych skutkach ubocznych⁵⁰.
Zachęcanie do aktywnego udziału w podejmowaniu decyzji dotyczących leczenia⁵¹.
Wspieranie samokontroli i samodzielnego zarządzania chorobą⁵².
Pomoc w opracowaniu skutecznych strategii radzenia sobie z fizycznymi i emocjonalnymi wyzwaniami związanymi z CML⁵³.

Badania wykazały, że wzmocnienie pozycji pacjenta w zarządzaniu CML może prowadzić do lepszych wyników leczenia i jakości życia⁵⁴.

Opieka wspierająca i zarządzanie objawami

Pacjenci z CML często doświadczają różnorodnych objawów i skutków ubocznych związanych z chorobą i jej leczeniem. Pielęgniarki odgrywają kluczową rolę w zarządzaniu tymi objawami i zapewnianiu opieki wspierającej.

Zarządzanie skutkami ubocznymi leczenia

Inhibitory kinazy tyrozynowej (TKI), choć skuteczne w leczeniu CML, mogą powodować różne skutki uboczne, które wpływają na jakość życia pacjenta i przestrzeganie zaleceń terapeutycznych⁵⁵. Pielęgniarki powinny:

Informować pacjentów o potencjalnych skutkach ubocznych TKI, takich jak nudności, wypadanie włosów i zwiększone ryzyko krwawienia⁵⁶.
Monitorować i zarządzać skutkami ubocznymi, które, choć łagodne, mogą stać się trudne do zniesienia dla pacjenta, jeśli utrzymują się przez dłuższy czas⁵⁷.
Współpracować z lekarzami w celu dostosowania dawki leku lub zmiany terapii w przypadku nietolerancji⁵⁸.
Zapewniać strategie łagodzenia typowych skutków ubocznych, takich jak zmęczenie, nudności, biegunka i wysypki skórne⁵⁹.

Wsparcie żywieniowe

Odpowiednie odżywianie może pomóc wzmocnić układ odpornościowy pacjenta, zmniejszając ryzyko infekcji i poprawiając ogólny stan zdrowia⁶⁰.

Interwencje pielęgniarskie:

Ocena stanu odżywienia pacjenta i identyfikacja potencjalnych problemów, takich jak utrata apetytu, nudności czy zmiany smaku⁶¹.
Zapewnienie porad żywieniowych, w tym zalecenia dotyczące bogatych w białko i kalorycznych pokarmów, które mogą pomóc w utrzymaniu siły i zapobieganiu utracie wagi⁶².
Współpraca z dietetykami w celu opracowania spersonalizowanych planów żywieniowych dostosowanych do potrzeb i preferencji pacjenta⁶³.
Monitorowanie stanu nawodnienia i bilansu płynów, szczególnie u pacjentów z wymiotami lub biegunką⁶⁴.

Wsparcie psychospołeczne

CML może mieć znaczący wpływ na zdrowie psychiczne i emocjonalne pacjenta. Pielęgniarki powinny zapewniać kompleksowe wsparcie psychospołeczne, które obejmuje:

Ocenę potrzeb emocjonalnych i społecznych pacjenta⁶⁵.
Zapewnienie informacji o dostępnych zasobach wsparcia, takich jak grupy wsparcia dla osób z białaczką i usługi doradztwa⁶⁶.
Wspieranie pacjenta w rozwijaniu strategii radzenia sobie ze stresem, lękiem i depresją⁶⁷.
Zachęcanie do utrzymywania kontaktów społecznych i aktywności, które sprawiają przyjemność⁶⁸.
Włączanie rodziny i opiekunów w proces opieki i zapewnianie im wsparcia⁶⁹.

Długoterminowa obserwacja i opieka nad pacjentem przeżywającym chorobę

CML wymaga długoterminowej obserwacji i opieki, nawet po osiągnięciu remisji. Pielęgniarki odgrywają ważną rolę w zarządzaniu długoterminową opieką nad pacjentami z CML.

Monitorowanie i nadzór

Regularne monitorowanie jest niezbędne do oceny efektywności leczenia i wczesnego wykrycia nawrotu choroby⁷⁰. Plan monitorowania powinien obejmować:

Regularne badania krwi do monitorowania liczby krwinek i poziomu transkryptu BCR-ABL⁷¹.
Okresowe badania szpiku kostnego w celu oceny obecności chromosomu Philadelphia⁷².
Monitorowanie odpowiedzi na leczenie na poziomie hematologicznym, cytogenetycznym i molekularnym⁷³.
Ocenę potencjalnych długoterminowych skutków leczenia TKI⁷⁴.

Pielęgniarki powinny edukować pacjentów na temat znaczenia regularnych wizyt kontrolnych i zachęcać do przestrzegania zalecanego harmonogramu badań⁷⁵.

Remisja bez leczenia

U niektórych pacjentów z głęboką i długotrwałą odpowiedzią molekularną można rozważyć przerwanie leczenia TKI, co nazywane jest remisją bez leczenia (TFR)⁷⁶. Rola pielęgniarki w tym procesie obejmuje:

Edukację pacjenta na temat kryteriów kwalifikacji do TFR⁷⁷.
Wyjaśnienie korzyści z TFR, takich jak zmniejszenie przewlekłych skutków ubocznych, zapobieganie długoterminowej toksyczności, poprawa jakości życia i ograniczenie kosztów⁷⁸.
Szczegółowe monitorowanie pacjentów w TFR pod kątem wczesnych oznak nawrotu⁷⁹.
Wsparcie pacjentów, którzy muszą wznowić leczenie TKI po utracie odpowiedzi molekularnej⁸⁰.

Opieka paliatywna i końca życia

W przypadku pacjentów z zaawansowaną fazą CML, którzy nie reagują na leczenie, ważne jest zapewnienie odpowiedniej opieki paliatywnej⁸¹. Pielęgniarki mogą:

Zapewniać leczenie objawowe w celu łagodzenia bólu i innych objawów⁸².
Wspierać pacjenta i jego rodzinę w podejmowaniu decyzji dotyczących opieki końca życia⁸³.
Koordynować opiekę paliatywną w domu, jeśli jest to preferowane przez pacjenta⁸⁴.
Zapewniać wsparcie emocjonalne i duchowe pacjentowi i jego bliskim⁸⁵.

Rola wyspecjalizowanej opieki pielęgniarskiej w CML

Wyspecjalizowane role pielęgniarskie, takie jak Pielęgniarka Ekspert Kliniczny (CEN) lub Pielęgniarka Koordynator Opieki (CMN), są coraz bardziej uznawane za kluczowe w opiece nad pacjentami z CML⁸⁶.

Zarządzanie przypadkiem i koordynacja opieki

Pielęgniarki pełniące funkcję koordynatorów opieki odgrywają kluczową rolę w zapewnieniu ciągłości i kompleksowości opieki nad pacjentem z CML⁸⁷. Ich zadania obejmują:

Koordynację opieki między różnymi specjalistami i usługami⁸⁸.
Zapewnienie pacjentowi wsparcia w nawigacji przez system opieki zdrowotnej⁸⁹.
Monitorowanie przestrzegania zaleceń terapeutycznych i odpowiedzi na leczenie⁹⁰.
Ułatwianie komunikacji między pacjentem a zespołem medycznym⁹¹.

Zaawansowana praktyka pielęgniarska w CML

Pielęgniarki z zaawansowaną praktyką, takie jak pielęgniarki specjalistki i zaawansowani praktykujący pielęgniarze, mogą oferować specjalistyczną opiekę pacjentom z CML⁹². Ich rola może obejmować:

Przeprowadzanie kompleksowych ocen stanu zdrowia i diagnozowanie problemów zdrowotnych⁹³.
Zalecanie i modyfikowanie planów leczenia we współpracy z lekarzami⁹⁴.
Prowadzenie edukacji pacjenta i rodziny na temat choroby i jej leczenia⁹⁵.
Prowadzenie badań i wdrażanie innowacji w opiece nad pacjentem z CML⁹⁶.

Innowacje w opiece pielęgniarskiej nad pacjentem z CML

Rozwój technologii i nowych podejść do opieki zdrowotnej otwiera nowe możliwości w dziedzinie opieki pielęgniarskiej nad pacjentami z CML.

Telemedycyna i zdalne monitorowanie

Telemedycyna i zdalne monitorowanie mogą zwiększyć dostęp do opieki, szczególnie dla pacjentów mieszkających w odległych obszarach lub mających trudności z częstymi wizytami w ośrodkach specjalistycznych⁹⁷.

Monitorowanie transkryptu BCR-ABL1 za pomocą kapilarnej krwi wysuszonej (DCB) ma potencjał poprawy zgodności z monitorowaniem molekularnym CML, umożliwiając lokalne pobieranie próbek inicjowane przez pacjenta za pomocą zwykłej poczty⁹⁸.
Technologia ta może być bardzo przydatna do kontynuowania monitorowania pacjentów w przyszłych pandemiach, gdzie monitorowanie domowe ograniczyłoby ryzyko narażenia towarzyszące wizytom w klinice⁹⁹.
Telemedycyna może również umożliwić zdalne konsultacje i edukację, zmniejszając potrzebę częstych wizyt w klinice¹⁰⁰.

Modele opieki skoncentrowane na pacjencie

Proaktywne modele opieki skoncentrowane na pacjencie są coraz częściej stosowane w opiece nad pacjentami z CML¹⁰¹. Te modele charakteryzują się:

Uwzględnieniem celów i preferencji pacjenta w planowaniu opieki¹⁰².
Wspieraniem samorządności i aktywnego udziału pacjenta w procesie leczenia¹⁰³.
Personalizacją komunikacji i edukacji w oparciu o potrzeby informacyjne i edukacyjne pacjenta¹⁰⁴.
Całościowym podejściem do opieki, uwzględniającym fizyczne, emocjonalne i społeczne potrzeby pacjenta¹⁰⁵.

Multidyscyplinarne podejście do opieki nad pacjentem z CML

Skuteczna opieka nad pacjentem z CML wymaga współpracy wielu specjalistów, z pielęgniarkami pełniącymi kluczową rolę w koordynacji tej opieki¹⁰⁶.

Współpraca z zespołem medycznym

Pielęgniarki współpracują z różnymi członkami zespołu medycznego, takimi jak:

Hematolodzy-onkolodzy, którzy specjalizują się w leczeniu pacjentów z CML¹⁰⁷.
Farmaceuci, którzy pomagają w zarządzaniu terapią lekową i monitorowaniu interakcji leków¹⁰⁸.
Dietetycy, którzy zapewniają porady żywieniowe dostosowane do potrzeb pacjenta¹⁰⁹.
Pracownicy socjalni, którzy pomagają pacjentom w dostępie do zasobów finansowych i społecznych¹¹⁰.
Psycholodzy i doradcy, którzy zapewniają wsparcie emocjonalne i psychologiczne¹¹¹.

Zaangażowanie pacjenta i rodziny

Zaangażowanie pacjenta i jego rodziny jest kluczowym elementem multidyscyplinarnego podejścia do opieki nad CML¹¹². Pielęgniarki mogą wspierać to zaangażowanie poprzez:

Zachęcanie pacjentów do zadawania pytań i wyrażania obaw dotyczących ich opieki¹¹³.
Zapewnianie jasnych i zrozumiałych informacji na temat choroby, leczenia i opcji opieki¹¹⁴.
Włączanie członków rodziny i opiekunów w edukację i planowanie opieki¹¹⁵.
Wspieranie rodzin i opiekunów w zapewnianiu emocjonalnego wsparcia i pomocy w codziennych potrzebach, w tym w transporcie na leczenie i zapewnieniu przestrzegania zaleceń dotyczących leków¹¹⁶.

Podsumowanie

Opieka pielęgniarska nad pacjentami z przewlekłą białaczką szpikową wymaga kompleksowego, multidyscyplinarnego podejścia, które uwzględnia zarówno fizyczne, jak i psychospołeczne potrzeby pacjenta. Pielęgniarki odgrywają kluczową rolę w ocenie i monitorowaniu pacjentów, zarządzaniu objawami, edukacji pacjentów i koordynacji opieki¹¹⁷.

Priorytetami w opiece pielęgniarskiej nad pacjentami z CML są minimalizacja ryzyka infekcji poprzez kontrolę zakażeń, zarządzanie skutkami ubocznymi leczenia, kontrola bólu, zapewnienie wsparcia emocjonalnego oraz prowadzenie edukacji zdrowotnej¹¹⁸.

Wraz z wprowadzeniem inhibitorów kinazy tyrozynowej, CML przekształciła się z potencjalnie śmiertelnej choroby w schorzenie przewlekłe, które może być skutecznie zarządzane przez długi czas. Pielęgniarki mają unikalną możliwość wsparcia pacjentów w adaptacji do życia z przewlekłą chorobą, pomagając im osiągnąć optymalną jakość życia i wyniki leczenia¹¹⁹¹²⁰.

Dzięki ciągłemu rozwojowi wiedzy i umiejętności, pielęgniarki mogą nadal odgrywać istotną rolę w poprawie opieki nad pacjentami z CML, wspierając ich od momentu diagnozy, przez leczenie, aż po długoterminową obserwację i, w niektórych przypadkach, remisję bez leczenia¹²¹.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis
https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml
Chronic myeloid leukemia (CML) is blood cancer that starts in the blood-forming myeloid cells or stem cells in your bone marrow. Healthcare providers treat CML with innovative therapies that have turned CML from being a potentially life-threatening illness into a chronic illness. […] Many people with CML may have normal life spans, thanks to therapy that has turned the condition from a life-threatening illness into a chronic illness that medication can manage. […] Prompt treatment keeps CML from getting worse. Without treatment, chronic myeloid leukemia can become a life-threatening illness within three to four years. […] Healthcare providers typically treat chronic phase CML with tyrosine kinase inhibitors (TKIs). TKIs are a type of targeted therapy. In CML, the targets are the abnormal BCR-ABL enzymes that let abnormal white blood cells divide and multiply uncontrollably. TKIs block the enzymes so that CML cells start to die.
#2 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – MSD Manual Professional Edition
https://www.msdmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml
Chronic myeloid leukemia (CML) occurs when a pluripotent stem cell undergoes malignant transformation and clonal myeloproliferation, leading to a striking overproduction of mature and immature granulocytes. […] Treatment is with tyrosine kinase inhibitors (TKI) such as imatinib, dasatinib, nilotinib, bosutinib, and ponatinib, which significantly improve response and prolong survival. Myelosuppressive drugs (eg, hydroxyurea), stem cell transplantation, and interferon alfa are also sometimes used. […] Treatment of chronic myeloid leukemia depends on the stage of disease. In the asymptomatic chronic phase, tyrosine kinase inhibitors (eg, imatinib, nilotinib, dasatinib, bosutinib, ponatinib) are the initial treatment choice; they are not curative but are extremely effective. […] Allogeneic hematopoietic stem cell transplantation is reserved for patients with accelerated or blast phase CML or those with disease resistant to the available tyrosine kinase inhibitors.
#3 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis
https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml
Chronic myeloid leukemia (CML) is blood cancer that starts in the blood-forming myeloid cells or stem cells in your bone marrow. Healthcare providers treat CML with innovative therapies that have turned CML from being a potentially life-threatening illness into a chronic illness. […] Many people with CML may have normal life spans, thanks to therapy that has turned the condition from a life-threatening illness into a chronic illness that medication can manage. […] Prompt treatment keeps CML from getting worse. Without treatment, chronic myeloid leukemia can become a life-threatening illness within three to four years. […] Healthcare providers typically treat chronic phase CML with tyrosine kinase inhibitors (TKIs). TKIs are a type of targeted therapy. In CML, the targets are the abnormal BCR-ABL enzymes that let abnormal white blood cells divide and multiply uncontrollably. TKIs block the enzymes so that CML cells start to die.
#4 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
Chronic myeloid leukaemia (CML) is a myeloproliferative neoplasm. […] The aim of the project was to define patient-oriented care processes, based on a proactive approach that can fully respond to the new health needs of CML patients. […] The Nurse Case Manager or Nursing Clinical Experts were identified as key people for the management of the side effects of treatment, the promotion of the therapeutic adherence and the evaluation of efficacy and effectiveness of the process through the identification of specific indicators for structure, process and outcome. […] The focal areas of the care process were identified so as to define a different approach to the CML patient, through a holistic view of care and the multidisciplinary interventions. […] Health care organizations should introduce Clinical Expert Nurses (CEN) or Case Manager Nurses (CMN) in the care pathways of CML patients.
#5 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#6 Chronic myeloid leukaemia (CML) – Leukaemia Foundation
https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/
Chronic myeloid leukaemia (CML) is a type of cancer that affects the blood and bone marrow. In CML the bone marrow produces too many white cells, called granulocytes. These cells (sometimes called blasts or leukaemic blasts) gradually crowd the bone marrow, interfering with normal blood cell production. They also spill out of the bone marrow and circulate around the body in the bloodstream. Because they are not fully mature, they are unable to work properly to fight infections. Over time, a shortage of red cells and platelets can cause anaemia, bleeding and/or bruising. […] Most people (more than 90%) are diagnosed in the early chronic phase of CML. Blood counts remain relatively stable and the proportion of blast cells in the bone marrow and blood is low (five per cent or less). Most people are generally well at this stage and have few, if any, troubling symptoms of their disease.
#7 Chronic Myeloid Leukemia | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)
https://www.yourcancercare.com/types-of-cancer/leukemia/chronic-myeloid-leukemia
More importantly, in patients with a complete cytogenetic remission a test called polymerase chain reaction (PCR) can determine the completeness of a molecular remission by measuring the presence of the BCR-ABL gene. […] As a general rule, the greater the degree of molecular response the longer the survival of an individual patient. […] Chronic Phase: Patients in the chronic phase of CML have stable disease with only minor symptoms, no cancer outside the bone marrow or spleen and white blood cell and platelet blood counts that are usually greater than normal. […] Accelerated Phase: When chronic myeloid leukemia is difficult to control with Gleevec (imatinib) or other therapies, the white blood count begins to increase. […] A diagnosis of accelerated phase requires at least one of the following: The persistent presence of 10-30% myeloblasts in the bone marrow or peripheral blood. […] Blastic Phase: Greater than 30% myeloblasts in marrow or blood.
#8 Chronic Myeloid Leukemia | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)
https://www.yourcancercare.com/types-of-cancer/leukemia/chronic-myeloid-leukemia
More importantly, in patients with a complete cytogenetic remission a test called polymerase chain reaction (PCR) can determine the completeness of a molecular remission by measuring the presence of the BCR-ABL gene. […] As a general rule, the greater the degree of molecular response the longer the survival of an individual patient. […] Chronic Phase: Patients in the chronic phase of CML have stable disease with only minor symptoms, no cancer outside the bone marrow or spleen and white blood cell and platelet blood counts that are usually greater than normal. […] Accelerated Phase: When chronic myeloid leukemia is difficult to control with Gleevec (imatinib) or other therapies, the white blood count begins to increase. […] A diagnosis of accelerated phase requires at least one of the following: The persistent presence of 10-30% myeloblasts in the bone marrow or peripheral blood. […] Blastic Phase: Greater than 30% myeloblasts in marrow or blood.
#9 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
The standard first treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI), such as imatinib (Gleevec), nilotinib (Tasigna), dasatinib (Sprycel), bosutinib (Bosulif), or asciminib (Scemblix). […] Monitoring the person’s response to treatment is very important. Blood counts are checked often. The blood is also checked with a polymerase chain reaction (PCR) test to measure the amount of the BCR-ABL gene. The bone marrow is checked, too, to see if the Philadelphia chromosome is there. […] If the CML is responding well to treatment, 3 months after starting treatment, the person should have: A complete hematologic response (CHR), and Some type of cytogenetic response, and/or A reduction of the number of copies of BCR-ABL on the PCR test by 90% or more. […] If treatment is working well, 18 months after starting treatment, the person should have: A complete hematologic response (CHR), and A complete cytogenetic response (CCyR), and/or A major molecular response (MMR).
#10 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
If the leukemia doesn’t respond well to the first treatment, there are several options. Increasing the dose of the drug. This helps some people, although the higher dose often has worse side effects. […] An allogeneic stem cell transplant may be the best option for most patients who are young and healthy enough to have this treatment. Most doctors prefer that the leukemia be under control, preferably in remission, before starting the transplant procedure. […] Allogeneic SCT is less successful for blast phase CML than for earlier phases. Still, it’s the only known option that may cure the disease. It’s more likely to work if the CML can be brought back to the chronic phase before the transplant. […] Because most patients with blast phase CML can’t be cured, palliative treatment (treatment to relieve symptoms rather than cure the disease) is important.
#11 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
The WG suggests greater involvement of nurses proposing a proactive care model to take charge of the CML patients, implementing the Clinical Expert Nurse or the Nurse Case Manager specialized in the CML management in the clinical pathways. […] The reception should ensure and enforce the relationship between patients and health care facility, orienting, reassuring and optimizing time, spaces and resources. […] The mode and the frequency of dialogue in accordance with the patient and in relation to his information/education needs has to be customized, because, in many cases, poor therapy adhesion is attributable to unclear information. […] The nursing assessment should be performed using validated tools. […] Its recommended that nursing diagnoses are reported in the patients documentation.
#12 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#13 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#14 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#15 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#16 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Chronic myeloid leukemia (CML) comprises ~15 to 20% of all adult leukemias and the development of oral BCR::ABL1-targeted tyrosine kinase inhibitors (TKIs) has revolutionized management. […] Adherence to treatment and regular monitoring of treatment responses are crucial to achieve long-term survival as specific treatment response milestones map to risk for disease progression. […] The US National Comprehensive Cancer Network and European LeukemiaNet recommend monitoring every 36 months to confirm adherence to therapy and ensure treatment milestones are met and maintained. […] This study also identified disparities in testing based on race, ethnicity, and socioeconomic status. […] Dried blood spots (DBS) have a long history of use. […] DCB BCR::ABL1 transcript monitoring has the potential to improve CML molecular monitoring adherence by allowing local patient-initiated sample collection using regular mail.
#17 Chronic Myeloid Leukemia | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)
https://www.yourcancercare.com/types-of-cancer/leukemia/chronic-myeloid-leukemia
More importantly, in patients with a complete cytogenetic remission a test called polymerase chain reaction (PCR) can determine the completeness of a molecular remission by measuring the presence of the BCR-ABL gene. […] As a general rule, the greater the degree of molecular response the longer the survival of an individual patient. […] Chronic Phase: Patients in the chronic phase of CML have stable disease with only minor symptoms, no cancer outside the bone marrow or spleen and white blood cell and platelet blood counts that are usually greater than normal. […] Accelerated Phase: When chronic myeloid leukemia is difficult to control with Gleevec (imatinib) or other therapies, the white blood count begins to increase. […] A diagnosis of accelerated phase requires at least one of the following: The persistent presence of 10-30% myeloblasts in the bone marrow or peripheral blood. […] Blastic Phase: Greater than 30% myeloblasts in marrow or blood.
#18 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
Goals and expected outcomes may include: The client will identify actions to prevent/reduce risk of infection. The client will demonstrate techniques, and lifestyle changes to promote a safe environment, and achieve timely healing. […] Therapeutic interventions and nursing actions for patients with leukemia may include: Promoting Infection Control and Management, Managing Fluid Volume, Managing Acute Pain, Enhancing Tolerance to Activity, Initiating Health Teachings and Patient Education, Assessing and Monitoring for Potential Complications, Administering Medications and Pharmacologic Support, Monitoring Laboratory and Diagnostic Procedures. […] Clients with leukemia are at risk for infection due to the diseases impact on the bone marrow and immune system. […] Infection prevention strategies are essential in reducing the risk of complications and ensuring optimal treatment outcomes.
#19 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#20 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#21 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#22
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8178
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. […] Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Avoid infections such as COVID-19, colds, and influenza (flu). Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu vaccine every year. Stay up to date on your COVID-19 vaccines. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have a fever or chills. Or you may be sweating. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You are much more tired than usual. You have swollen glands in your armpits, groin, or neck. You do not get better as expected.
#23
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf8178
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. […] Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Avoid infections such as COVID-19, colds, and influenza (flu). Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu vaccine every year. Stay up to date on your COVID-19 vaccines. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have a fever or chills. Or you may be sweating. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: You are much more tired than usual. You have swollen glands in your armpits, groin, or neck. You do not get better as expected.
#24 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#25 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#26 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#27 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#28 Leukemia: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether
https://www.nursetogether.com/leukemia-nursing-diagnosis-care-plan/
Immunotherapy (biologic therapy) strengthens the bodys immune system to fight leukemia. […] Patients with leukemia are at risk for developing infections as they have a low white blood cell count and a compromised immune system. […] Patients with leukemia may require the replacement of red blood cells and platelets related to the disease process. […] Providing adequate nutrition can help enhance the patients immune system, reducing the risk of infection.
#29 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#30 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#31 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#32 Chronic Myeloid Leukemia: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-myeloid-leukemia-care-instructions.uf8178
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. […] Get enough sleep, and take time to do things you enjoy. This can help reduce stress. […] Think about joining a support group. Or discuss your concerns with your doctor or a counselor. […] Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines.
#33 Chronic Myeloid Leukemia: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-myeloid-leukemia-care-instructions.uf8178
Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good. […] Watch closely for changes in your health, and be sure to contact your doctor if you: You are much more tired than usual. You have swollen glands in your armpits, groin, or neck. You do not get better as expected.
#34 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#35 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#36 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#37 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
In this article, we will discuss leukemia nursing care plans and nursing diagnosis that nurses can use to provide effective care for their patients. We will provide a detailed explanation of each plan and diagnosis, as well as tips for implementing effective nursing interventions. […] The nursing management and care plan for patients with leukemia involve several important aspects. Nurses play a crucial role in assessing and monitoring patients, managing symptoms, and providing support throughout the treatment journey. […] The following are the nursing priorities for patients with leukemia: Minimizing infection through infection control, Managing side effects of chemotherapy, Managing pain, Providing emotional support, Providing health teachings. […] Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with leukemia based on the nurses clinical judgement and understanding of the patients unique health condition.
#38 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
Goals and expected outcomes may include: The client will identify actions to prevent/reduce risk of infection. The client will demonstrate techniques, and lifestyle changes to promote a safe environment, and achieve timely healing. […] Therapeutic interventions and nursing actions for patients with leukemia may include: Promoting Infection Control and Management, Managing Fluid Volume, Managing Acute Pain, Enhancing Tolerance to Activity, Initiating Health Teachings and Patient Education, Assessing and Monitoring for Potential Complications, Administering Medications and Pharmacologic Support, Monitoring Laboratory and Diagnostic Procedures. […] Clients with leukemia are at risk for infection due to the diseases impact on the bone marrow and immune system. […] Infection prevention strategies are essential in reducing the risk of complications and ensuring optimal treatment outcomes.
#39 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
Goals and expected outcomes may include: The client will identify actions to prevent/reduce risk of infection. The client will demonstrate techniques, and lifestyle changes to promote a safe environment, and achieve timely healing. […] Therapeutic interventions and nursing actions for patients with leukemia may include: Promoting Infection Control and Management, Managing Fluid Volume, Managing Acute Pain, Enhancing Tolerance to Activity, Initiating Health Teachings and Patient Education, Assessing and Monitoring for Potential Complications, Administering Medications and Pharmacologic Support, Monitoring Laboratory and Diagnostic Procedures. […] Clients with leukemia are at risk for infection due to the diseases impact on the bone marrow and immune system. […] Infection prevention strategies are essential in reducing the risk of complications and ensuring optimal treatment outcomes.
#40 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#41 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#42 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#43 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#44 Chronic myeloid leukemia | Conditions | UCSF Health
https://www.ucsfhealth.org/conditions/chronic-myeloid-leukemia
Tyrosine kinase inhibitors (TKIs) are drugs used for targeted therapy. They block the protein produced by the BCR-ABL gene that makes white blood cells multiply uncontrollably. These drugs include imatinib (Gleevec), dasatinib (Sprycel) and nilotinib (Tasigna). They’re taken orally. […] Another highly effective option for treating CML is a stem cell or bone marrow transplant (BMT). Typically, the transplant uses stem cells collected from a matched donor, a process called allogeneic transplant. This is a risky procedure, with a treatment-related death rate of 15 to 20%, so it’s only for patients who don’t respond to TKIs. […] UCSF is dedicated to improving outcomes for patients with CML. Interested patients may have opportunities to participate in clinical trials investigating promising treatments for chronic myeloid leukemia.
#45 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#46 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#47 Nursing Care Management of Chronic Myeloid Leukemia–A Case Report. – Document – Gale Academic OneFile
https://go.gale.com/ps/i.do?id=GALE%7CA659845491&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=22784748&p=AONE&sw=w
Excessive growth of mature granulocytes in the bone marrow induces chronic myeloid leukemia. The patient received imatinib, which was modified to nilotinib 300 mg PO bid due to imatinib intolerance. Thrombocytopenia (65 * 109 cells / L) developed a month later, and the dosage of nilotinib was reduced to 200 mg of PO. […] Patient was susceptible to infection due to inadequate primary defences. Hence, the patient was placed in a private room.
#48 Follow-up after treatment for chronic myeloid leukemia | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/follow-up
You will need regular follow-up visits with your healthcare team for many years after treatment even if there are no signs of CML. […] If you are on targeted therapy with TKIs, follow-up visits are usually scheduled: every 3 months for 2 years from the start of treatment; every 3 to 6 months for the rest of your life once there is a molecular response. […] During a follow-up visit, your healthcare team will talk to you about the TKIs you are prescribed to make sure you are taking them correctly. They will also follow up with you on your regular testing to monitor the disease and make sure the TKIs are working. […] Tell your healthcare team about any vitamins, supplements or drugs you are taking, including natural health products and cannabis or other recreational drugs. These can affect how well TKIs can treat CML, so it’s important to tell them about anything you are taking.
#49 Follow-up after treatment for chronic myeloid leukemia | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/follow-up
You will need regular follow-up visits with your healthcare team for many years after treatment even if there are no signs of CML. […] If you are on targeted therapy with TKIs, follow-up visits are usually scheduled: every 3 months for 2 years from the start of treatment; every 3 to 6 months for the rest of your life once there is a molecular response. […] During a follow-up visit, your healthcare team will talk to you about the TKIs you are prescribed to make sure you are taking them correctly. They will also follow up with you on your regular testing to monitor the disease and make sure the TKIs are working. […] Tell your healthcare team about any vitamins, supplements or drugs you are taking, including natural health products and cannabis or other recreational drugs. These can affect how well TKIs can treat CML, so it’s important to tell them about anything you are taking.
#50 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#51 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
Targeted therapy drugs are the main treatment for chronic myeloid leukemia (CML), but some patients might also need other treatments. […] Treatment options for people with chronic myeloid leukemia (CML) depend on the phase of their disease (chronic, accelerated, or blast phase), their age, other prognostic factors, and the availability of a stem cell donor with matching tissue type. […] You might have many other specialists on your treatment team as well, including physician assistants, nurse practitioners, nurses, nutrition specialists, social workers, and other health professionals. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision.
#52 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#53 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#54 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#55 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#56 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#57 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#58 Nursing Care Management of Chronic Myeloid Leukemia–A Case Report. – Document – Gale Academic OneFile
https://go.gale.com/ps/i.do?id=GALE%7CA659845491&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=22784748&p=AONE&sw=w
Excessive growth of mature granulocytes in the bone marrow induces chronic myeloid leukemia. The patient received imatinib, which was modified to nilotinib 300 mg PO bid due to imatinib intolerance. Thrombocytopenia (65 * 109 cells / L) developed a month later, and the dosage of nilotinib was reduced to 200 mg of PO. […] Patient was susceptible to infection due to inadequate primary defences. Hence, the patient was placed in a private room.
#59 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#60 Leukemia: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether
https://www.nursetogether.com/leukemia-nursing-diagnosis-care-plan/
Immunotherapy (biologic therapy) strengthens the bodys immune system to fight leukemia. […] Patients with leukemia are at risk for developing infections as they have a low white blood cell count and a compromised immune system. […] Patients with leukemia may require the replacement of red blood cells and platelets related to the disease process. […] Providing adequate nutrition can help enhance the patients immune system, reducing the risk of infection.
#61 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Your care may include support from a dietitian to boost energy and help you get more of the nutrients you need. […] Older patients may respond differently to treatments or experience more severe side effects. We adjust therapies and coordinate extra support, when needed, so your care keeps moving forward.
#62 Chronic Myeloid Leukemia: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-myeloid-leukemia-care-instructions.uf8178
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. […] Get enough sleep, and take time to do things you enjoy. This can help reduce stress. […] Think about joining a support group. Or discuss your concerns with your doctor or a counselor. […] Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines.
#63 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Your care may include support from a dietitian to boost energy and help you get more of the nutrients you need. […] Older patients may respond differently to treatments or experience more severe side effects. We adjust therapies and coordinate extra support, when needed, so your care keeps moving forward.
#64 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
Clients with leukemia are at risk for deficient fluid volume due to several factors, including excessive losses through vomiting, diarrhea, or bleeding, decreased fluid intake due to poor appetite, and increased fluid needs resulting from fever or chemotherapy. […] Effective pain management is essential to alleviate suffering, enhance quality of life, and promote patient comfort. […] Enhancing tolerance to activity in patients with leukemia is an essential aspect of their care and rehabilitation. […] Health teachings and patient education empower individuals to make informed decisions, manage treatment-related symptoms, and adopt healthy lifestyle practices. […] Through vigilant assessment and monitoring, nurses play a critical role in identifying signs of infection, bleeding, organ dysfunction, and other potential complications.
#65 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Leukemia patients often experience fatigue, infection risk, bleeding, and emotional distress. Nurses must focus on managing these symptoms and providing education and support throughout the treatment process. […] Monitor CBC and differential: Watch for signs of increased risk for infection (neutropenia), anemia, and thrombocytopenia. […] Evaluate for signs of infection: Fever, chills, and any new symptoms should be reported immediately, as leukemia patients are immunocompromised. […] Assess bleeding: Look for petechiae, bruising, and bleeding gums, particularly in thrombocytopenic patients. […] Psychosocial assessment: Determine the patients coping mechanisms, support system, and need for psychological support. […] Risk for infection related to leukopenia and immunosuppressive treatments
#66 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Risk for bleeding related to thrombocytopenia and bone marrow suppression […] Fatigue related to anemia and the effects of chemotherapy […] Disturbed body image related to hair loss, weight loss, and pallor from leukemia treatment. […] Infection prevention: Implement neutropenic precautions, such as hand hygiene, limiting visitors, and avoiding exposure to infectious agents. […] Bleeding precautions: Educate the patient on avoiding activities that may lead to injury, using soft toothbrushes, and avoiding over-the-counter medications like aspirin. […] Supportive care: Provide energy-conserving strategies for managing fatigue, such as frequent rest periods and small, nutrient-dense meals. […] Emotional support: Offer counseling services and encourage participation in leukemia support groups. Assist patients with coping strategies and body image issues, including hair loss management.
#67 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422
Talk to your health care provider about your side effects. Powerful cancer medicines can cause many side effects. […] Don’t stop treatment on your own. […] Ask for help if you’re having trouble coping. […] Learn enough about chronic myelogenous leukemia to make decisions about your care. […] Stay connected to friends and family. […] Find someone to talk with.
#68 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422
Talk to your health care provider about your side effects. Powerful cancer medicines can cause many side effects. […] Don’t stop treatment on your own. […] Ask for help if you’re having trouble coping. […] Learn enough about chronic myelogenous leukemia to make decisions about your care. […] Stay connected to friends and family. […] Find someone to talk with.
#69 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#70 Follow-up after treatment for chronic myeloid leukemia | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/follow-up
Follow-up care for chronic myeloid leukemia (CML) lets your healthcare team keep track of your health. This important part of cancer care is often shared among the cancer specialists and your family doctor. […] Because you will be on tyrosine kinase inhibitors (TKIs) for as long as they continue to control CML, you will have follow-up care for the rest of your life. Your healthcare team will regularly check the number of cells with the BCR-ABL gene in the blood and bone marrow to make sure TKI treatment is working. They will also help you manage or recover from side effects of treatment. […] Follow-up care may not seem that important to you, especially if your treatment was long or very hard. You may find the idea of follow-up stressful because it reminds you of your cancer experience or because you are worried about what a test might reveal. Talk to your healthcare team about how you feel and about why follow-up matters. Your healthcare team is there to help.
#71 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
The standard first treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI), such as imatinib (Gleevec), nilotinib (Tasigna), dasatinib (Sprycel), bosutinib (Bosulif), or asciminib (Scemblix). […] Monitoring the person’s response to treatment is very important. Blood counts are checked often. The blood is also checked with a polymerase chain reaction (PCR) test to measure the amount of the BCR-ABL gene. The bone marrow is checked, too, to see if the Philadelphia chromosome is there. […] If the CML is responding well to treatment, 3 months after starting treatment, the person should have: A complete hematologic response (CHR), and Some type of cytogenetic response, and/or A reduction of the number of copies of BCR-ABL on the PCR test by 90% or more. […] If treatment is working well, 18 months after starting treatment, the person should have: A complete hematologic response (CHR), and A complete cytogenetic response (CCyR), and/or A major molecular response (MMR).
#72 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
The standard first treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI), such as imatinib (Gleevec), nilotinib (Tasigna), dasatinib (Sprycel), bosutinib (Bosulif), or asciminib (Scemblix). […] Monitoring the person’s response to treatment is very important. Blood counts are checked often. The blood is also checked with a polymerase chain reaction (PCR) test to measure the amount of the BCR-ABL gene. The bone marrow is checked, too, to see if the Philadelphia chromosome is there. […] If the CML is responding well to treatment, 3 months after starting treatment, the person should have: A complete hematologic response (CHR), and Some type of cytogenetic response, and/or A reduction of the number of copies of BCR-ABL on the PCR test by 90% or more. […] If treatment is working well, 18 months after starting treatment, the person should have: A complete hematologic response (CHR), and A complete cytogenetic response (CCyR), and/or A major molecular response (MMR).
#73 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
The standard first treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI), such as imatinib (Gleevec), nilotinib (Tasigna), dasatinib (Sprycel), bosutinib (Bosulif), or asciminib (Scemblix). […] Monitoring the person’s response to treatment is very important. Blood counts are checked often. The blood is also checked with a polymerase chain reaction (PCR) test to measure the amount of the BCR-ABL gene. The bone marrow is checked, too, to see if the Philadelphia chromosome is there. […] If the CML is responding well to treatment, 3 months after starting treatment, the person should have: A complete hematologic response (CHR), and Some type of cytogenetic response, and/or A reduction of the number of copies of BCR-ABL on the PCR test by 90% or more. […] If treatment is working well, 18 months after starting treatment, the person should have: A complete hematologic response (CHR), and A complete cytogenetic response (CCyR), and/or A major molecular response (MMR).
#74 Follow-up after treatment for chronic myeloid leukemia | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/follow-up
You will need regular follow-up visits with your healthcare team for many years after treatment even if there are no signs of CML. […] If you are on targeted therapy with TKIs, follow-up visits are usually scheduled: every 3 months for 2 years from the start of treatment; every 3 to 6 months for the rest of your life once there is a molecular response. […] During a follow-up visit, your healthcare team will talk to you about the TKIs you are prescribed to make sure you are taking them correctly. They will also follow up with you on your regular testing to monitor the disease and make sure the TKIs are working. […] Tell your healthcare team about any vitamins, supplements or drugs you are taking, including natural health products and cannabis or other recreational drugs. These can affect how well TKIs can treat CML, so it’s important to tell them about anything you are taking.
#75 Follow-up after treatment for chronic myeloid leukemia | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/follow-up
Follow-up care for chronic myeloid leukemia (CML) lets your healthcare team keep track of your health. This important part of cancer care is often shared among the cancer specialists and your family doctor. […] Because you will be on tyrosine kinase inhibitors (TKIs) for as long as they continue to control CML, you will have follow-up care for the rest of your life. Your healthcare team will regularly check the number of cells with the BCR-ABL gene in the blood and bone marrow to make sure TKI treatment is working. They will also help you manage or recover from side effects of treatment. […] Follow-up care may not seem that important to you, especially if your treatment was long or very hard. You may find the idea of follow-up stressful because it reminds you of your cancer experience or because you are worried about what a test might reveal. Talk to your healthcare team about how you feel and about why follow-up matters. Your healthcare team is there to help.
#76 Chronic Myeloid Leukaemia (CML) | Leukaemia Care
https://www.leukaemiacare.org.uk/support-and-information/information-about-blood-cancer/blood-cancer-information/leukaemia/chronic-myeloid-leukaemia/
Chronic myeloid leukaemia (CML) is a slow-growing type of blood cancer. […] Treatment for chronic myeloid leukaemia (CML) is usually very effective. The main treatment is a targeted drug called a tyrosine kinase inhibitor (TKI). […] Response to treatment for chronic myeloid leukaemia (CML) is usually measured using a blood test called PCR. […] Treatment-free remission (TFR) is when your CML stays under control without the need to keep taking medicines. It might be possible for some people with CML who have a deep, long-term response to tyrosine kinase inhibitors (TKIs).
#77 Chronic Myelogenous Leukemia (CML) Treatment & Management: Approach Considerations, Imatinib, Newer Tyrosine Kinase Inhibitors
https://emedicine.medscape.com/article/199425-treatment
Splenectomy and splenic irradiation have been used in patients with large and painful spleens, usually in the late phase of CML. […] Molecular monitoring in CML is a powerful tool to document treatment responses and predict relapse. […] The cytogenetic response is monitored every 3-6 months. […] The goal is 100% normal cells after 1-2 years of therapy. […] Failure to achieve these milestones should trigger a reassessment of the therapeutic strategy. […] Discontinuing TKI therapy for certain patients, an approach first put forward in 2006, has the potential to reduce adverse effects associated with lifelong TKI therapy and to be cost-effective measure. […] Several guidelines provide recommendations on discontinuation of TKI treatment. […] In general, patients in the chronic phase of CML with a stable, prolonged, and deep molecular response (DMR) for 2 years might be ready to discontinue TKI therapy. […] If a patient wishes to stop treatment because of problems with the TKI, the physician should discuss with the patient the possibility of switching to a different TKI that might enable achievement of a deeper molecular response.
#78 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Given the effectiveness of CML therapy, enhanced monitoring access could be a lifesaving intervention. […] Loss of MMR is also the threshold at which TKI therapy is typically restarted in patients who have discontinued therapy, an intervention that can mitigate chronic side effects, prevent long-term toxicities, improve quality of life, and limit costs to patients and health care systems. […] However, due to the technical challenges of sampling larger blood volumes, one compromise is limit of detection driven by the smaller numbers of cells investigated. […] The technology could be very useful to continue monitoring patients in future pandemics, where home monitoring would limit the exposure risk that accompanies visits to the clinic.
#79 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis
https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml
Most people take TKIs for the rest of their lives. However, recent studies show CML remains in remission even after people stop taking TKIs. This is treatment-free remission. […] If you have chronic myeloid leukemia, you may need to take medication for the rest of your life. You’ll also need regular checkups so your healthcare provider can monitor your overall health. Theyâll look for signs that CML has come back and for signs of second cancers. […] In general, you should expect to see your provider every few months for the rest of your life. […] If you have CML, your healthcare provider is your best resource for information about what you can expect.
#80 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Given the effectiveness of CML therapy, enhanced monitoring access could be a lifesaving intervention. […] Loss of MMR is also the threshold at which TKI therapy is typically restarted in patients who have discontinued therapy, an intervention that can mitigate chronic side effects, prevent long-term toxicities, improve quality of life, and limit costs to patients and health care systems. […] However, due to the technical challenges of sampling larger blood volumes, one compromise is limit of detection driven by the smaller numbers of cells investigated. […] The technology could be very useful to continue monitoring patients in future pandemics, where home monitoring would limit the exposure risk that accompanies visits to the clinic.
#81 Treating Chronic Myeloid Leukemia by Phase | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/treating-by-phase.html
If the leukemia doesn’t respond well to the first treatment, there are several options. Increasing the dose of the drug. This helps some people, although the higher dose often has worse side effects. […] An allogeneic stem cell transplant may be the best option for most patients who are young and healthy enough to have this treatment. Most doctors prefer that the leukemia be under control, preferably in remission, before starting the transplant procedure. […] Allogeneic SCT is less successful for blast phase CML than for earlier phases. Still, it’s the only known option that may cure the disease. It’s more likely to work if the CML can be brought back to the chronic phase before the transplant. […] Because most patients with blast phase CML can’t be cured, palliative treatment (treatment to relieve symptoms rather than cure the disease) is important.
#82 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#83 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#84 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#85 Support at home if you have chronic myeloid leukaemia (CML) | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/living-with/support-home
You might need some care and support at home due to your chronic myeloid leukaemia, or its treatment. A lot of practical and emotional support is available to you. […] Community specialist palliative care nurses include Macmillan nurses and hospice nurses. They specialise in symptom management such as pain control, sickness, and other cancer symptoms. They also give emotional support to you and your carers. […] Marie Curie nurses give nursing care to people with advanced cancer in their own homes. They can visit during the day or spend the night in your home to give your carers a break. […] Social workers can help to support you with your situation at home. They can arrange home helps to help with shopping or housework, home care assistants for washing and dressing, meals on wheels, and respite care.
#86 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
Chronic myeloid leukaemia (CML) is a myeloproliferative neoplasm. […] The aim of the project was to define patient-oriented care processes, based on a proactive approach that can fully respond to the new health needs of CML patients. […] The Nurse Case Manager or Nursing Clinical Experts were identified as key people for the management of the side effects of treatment, the promotion of the therapeutic adherence and the evaluation of efficacy and effectiveness of the process through the identification of specific indicators for structure, process and outcome. […] The focal areas of the care process were identified so as to define a different approach to the CML patient, through a holistic view of care and the multidisciplinary interventions. […] Health care organizations should introduce Clinical Expert Nurses (CEN) or Case Manager Nurses (CMN) in the care pathways of CML patients.
#87 Treatment Planning | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/cancer/chronic-myeloid-leukemia/patient-care-resources/treatment-planning.html
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for leukemia have different goals, such as: Slowing or stopping the growth of cancer; Destroying cancer cells; Delaying or preventing cancer from coming back (recurrence); Managing symptoms of incurable cancer. […] Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. […] Your health care team for leukemia brings together a multispecialty team of experts dedicated to treating leukemia, blood cancer, and rare forms of blood disorders. […] Multidisciplinary care coordinators are specialized registered nurses who provide one-on-one support to guide you through the cancer treatment process. These coordinators serve as your point of contact to help manage your care, from your first appointment through follow-up visits.
#88 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#89 Treatment Planning | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/cancer/chronic-myeloid-leukemia/patient-care-resources/treatment-planning.html
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for leukemia have different goals, such as: Slowing or stopping the growth of cancer; Destroying cancer cells; Delaying or preventing cancer from coming back (recurrence); Managing symptoms of incurable cancer. […] Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. […] Your health care team for leukemia brings together a multispecialty team of experts dedicated to treating leukemia, blood cancer, and rare forms of blood disorders. […] Multidisciplinary care coordinators are specialized registered nurses who provide one-on-one support to guide you through the cancer treatment process. These coordinators serve as your point of contact to help manage your care, from your first appointment through follow-up visits.
#90 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#91 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
The WG suggests greater involvement of nurses proposing a proactive care model to take charge of the CML patients, implementing the Clinical Expert Nurse or the Nurse Case Manager specialized in the CML management in the clinical pathways. […] The reception should ensure and enforce the relationship between patients and health care facility, orienting, reassuring and optimizing time, spaces and resources. […] The mode and the frequency of dialogue in accordance with the patient and in relation to his information/education needs has to be customized, because, in many cases, poor therapy adhesion is attributable to unclear information. […] The nursing assessment should be performed using validated tools. […] Its recommended that nursing diagnoses are reported in the patients documentation.
#92 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
Targeted therapy drugs are the main treatment for chronic myeloid leukemia (CML), but some patients might also need other treatments. […] Treatment options for people with chronic myeloid leukemia (CML) depend on the phase of their disease (chronic, accelerated, or blast phase), their age, other prognostic factors, and the availability of a stem cell donor with matching tissue type. […] You might have many other specialists on your treatment team as well, including physician assistants, nurse practitioners, nurses, nutrition specialists, social workers, and other health professionals. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision.
#93 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
The WG suggests greater involvement of nurses proposing a proactive care model to take charge of the CML patients, implementing the Clinical Expert Nurse or the Nurse Case Manager specialized in the CML management in the clinical pathways. […] The reception should ensure and enforce the relationship between patients and health care facility, orienting, reassuring and optimizing time, spaces and resources. […] The mode and the frequency of dialogue in accordance with the patient and in relation to his information/education needs has to be customized, because, in many cases, poor therapy adhesion is attributable to unclear information. […] The nursing assessment should be performed using validated tools. […] Its recommended that nursing diagnoses are reported in the patients documentation.
#94 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
Targeted therapy drugs are the main treatment for chronic myeloid leukemia (CML), but some patients might also need other treatments. […] Treatment options for people with chronic myeloid leukemia (CML) depend on the phase of their disease (chronic, accelerated, or blast phase), their age, other prognostic factors, and the availability of a stem cell donor with matching tissue type. […] You might have many other specialists on your treatment team as well, including physician assistants, nurse practitioners, nurses, nutrition specialists, social workers, and other health professionals. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision.
#95 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#96 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Given the effectiveness of CML therapy, enhanced monitoring access could be a lifesaving intervention. […] Loss of MMR is also the threshold at which TKI therapy is typically restarted in patients who have discontinued therapy, an intervention that can mitigate chronic side effects, prevent long-term toxicities, improve quality of life, and limit costs to patients and health care systems. […] However, due to the technical challenges of sampling larger blood volumes, one compromise is limit of detection driven by the smaller numbers of cells investigated. […] The technology could be very useful to continue monitoring patients in future pandemics, where home monitoring would limit the exposure risk that accompanies visits to the clinic.
#97 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Chronic myeloid leukemia (CML) comprises ~15 to 20% of all adult leukemias and the development of oral BCR::ABL1-targeted tyrosine kinase inhibitors (TKIs) has revolutionized management. […] Adherence to treatment and regular monitoring of treatment responses are crucial to achieve long-term survival as specific treatment response milestones map to risk for disease progression. […] The US National Comprehensive Cancer Network and European LeukemiaNet recommend monitoring every 36 months to confirm adherence to therapy and ensure treatment milestones are met and maintained. […] This study also identified disparities in testing based on race, ethnicity, and socioeconomic status. […] Dried blood spots (DBS) have a long history of use. […] DCB BCR::ABL1 transcript monitoring has the potential to improve CML molecular monitoring adherence by allowing local patient-initiated sample collection using regular mail.
#98 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Chronic myeloid leukemia (CML) comprises ~15 to 20% of all adult leukemias and the development of oral BCR::ABL1-targeted tyrosine kinase inhibitors (TKIs) has revolutionized management. […] Adherence to treatment and regular monitoring of treatment responses are crucial to achieve long-term survival as specific treatment response milestones map to risk for disease progression. […] The US National Comprehensive Cancer Network and European LeukemiaNet recommend monitoring every 36 months to confirm adherence to therapy and ensure treatment milestones are met and maintained. […] This study also identified disparities in testing based on race, ethnicity, and socioeconomic status. […] Dried blood spots (DBS) have a long history of use. […] DCB BCR::ABL1 transcript monitoring has the potential to improve CML molecular monitoring adherence by allowing local patient-initiated sample collection using regular mail.
#99 Point-of-care BCR::ABL1 transcript monitoring using capillary dried blood in chronic myeloid leukemia patients | Leukemia
https://www.nature.com/articles/s41375-024-02285-9
Given the effectiveness of CML therapy, enhanced monitoring access could be a lifesaving intervention. […] Loss of MMR is also the threshold at which TKI therapy is typically restarted in patients who have discontinued therapy, an intervention that can mitigate chronic side effects, prevent long-term toxicities, improve quality of life, and limit costs to patients and health care systems. […] However, due to the technical challenges of sampling larger blood volumes, one compromise is limit of detection driven by the smaller numbers of cells investigated. […] The technology could be very useful to continue monitoring patients in future pandemics, where home monitoring would limit the exposure risk that accompanies visits to the clinic.
#100 Chronic Myeloid Leukemia Experts in CT, MD, and NJ – Regional Cancer Care Associates
https://www.regionalcancercare.org/cancer-types/leukemia/chronic-myeloid-leukemia/
CML has three phases. The chronic phase comes with relatively minor symptoms and is fairly easy to treat. The accelerated or blast phases, however, are more difficult to address. […] Because CML can accelerate quickly, its important to monitor the condition carefully and target treatment based on the diseases phase. Personalized treatment plans for patients with CML may include: […] You may also want to consider participating in a clinical trial for your treatment. A clinical trial is a carefully controlled research study that allows physicians to test the effectiveness of a promising new treatment. While doctors are learning better methods to treat cancer, patients receive affordable access to state-of-the-art treatments. […] If you or a loved one has been diagnosed with CML, Regional Cancer Care Associates is standing by to help. With numerous locations in Connecticut, Maryland, and New Jersey, we make the most advanced cancer treatments conveniently available to the communities we serve.
#101 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
The WG suggests greater involvement of nurses proposing a proactive care model to take charge of the CML patients, implementing the Clinical Expert Nurse or the Nurse Case Manager specialized in the CML management in the clinical pathways. […] The reception should ensure and enforce the relationship between patients and health care facility, orienting, reassuring and optimizing time, spaces and resources. […] The mode and the frequency of dialogue in accordance with the patient and in relation to his information/education needs has to be customized, because, in many cases, poor therapy adhesion is attributable to unclear information. […] The nursing assessment should be performed using validated tools. […] Its recommended that nursing diagnoses are reported in the patients documentation.
#102 Treatment Planning | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/cancer/chronic-myeloid-leukemia/patient-care-resources/treatment-planning.html
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for leukemia have different goals, such as: Slowing or stopping the growth of cancer; Destroying cancer cells; Delaying or preventing cancer from coming back (recurrence); Managing symptoms of incurable cancer. […] Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. […] Your health care team for leukemia brings together a multispecialty team of experts dedicated to treating leukemia, blood cancer, and rare forms of blood disorders. […] Multidisciplinary care coordinators are specialized registered nurses who provide one-on-one support to guide you through the cancer treatment process. These coordinators serve as your point of contact to help manage your care, from your first appointment through follow-up visits.
#103 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#104 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
The WG suggests greater involvement of nurses proposing a proactive care model to take charge of the CML patients, implementing the Clinical Expert Nurse or the Nurse Case Manager specialized in the CML management in the clinical pathways. […] The reception should ensure and enforce the relationship between patients and health care facility, orienting, reassuring and optimizing time, spaces and resources. […] The mode and the frequency of dialogue in accordance with the patient and in relation to his information/education needs has to be customized, because, in many cases, poor therapy adhesion is attributable to unclear information. […] The nursing assessment should be performed using validated tools. […] Its recommended that nursing diagnoses are reported in the patients documentation.
#105 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
Chronic myeloid leukaemia (CML) is a myeloproliferative neoplasm. […] The aim of the project was to define patient-oriented care processes, based on a proactive approach that can fully respond to the new health needs of CML patients. […] The Nurse Case Manager or Nursing Clinical Experts were identified as key people for the management of the side effects of treatment, the promotion of the therapeutic adherence and the evaluation of efficacy and effectiveness of the process through the identification of specific indicators for structure, process and outcome. […] The focal areas of the care process were identified so as to define a different approach to the CML patient, through a holistic view of care and the multidisciplinary interventions. […] Health care organizations should introduce Clinical Expert Nurses (CEN) or Case Manager Nurses (CMN) in the care pathways of CML patients.
#106 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.
#107 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS
https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment
It’s important that your doctor is experienced in treating patients with chronic myeloid leukemia (CML) or has access to a CML specialist. Doctors who specialize in treating patients with CML are called hematologist-oncologists. […] Tyrosine kinase inhibitor (TKI) therapy is standard treatment for chronic phase CML. TKIs are often successful at managing CML for long periods of time. […] After the start of therapy, doctors will monitor patients to determine how well a patient is responding to treatment. A patient who is responding well will stay on his or her current drug therapy. […] If the patients current treatment is not working, a BCR::ABL1 kinase domain mutation analysis should be done to check for mutations of the BCR::ABL1 gene. […] Treatment at a specialized center, with doctors who have expertise in treating CML patients, is recommended for patients in the accelerated phase of the disease.
#108 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#109 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Your care may include support from a dietitian to boost energy and help you get more of the nutrients you need. […] Older patients may respond differently to treatments or experience more severe side effects. We adjust therapies and coordinate extra support, when needed, so your care keeps moving forward.
#110 Support at home if you have chronic myeloid leukaemia (CML) | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/living-with/support-home
You might need some care and support at home due to your chronic myeloid leukaemia, or its treatment. A lot of practical and emotional support is available to you. […] Community specialist palliative care nurses include Macmillan nurses and hospice nurses. They specialise in symptom management such as pain control, sickness, and other cancer symptoms. They also give emotional support to you and your carers. […] Marie Curie nurses give nursing care to people with advanced cancer in their own homes. They can visit during the day or spend the night in your home to give your carers a break. […] Social workers can help to support you with your situation at home. They can arrange home helps to help with shopping or housework, home care assistants for washing and dressing, meals on wheels, and respite care.
#111 Treating Chronic Myeloid Leukemia | American Cancer Society
https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html
People with cancer need support and information, no matter what stage of illness they may be in. […] Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.
#112 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Chronic myeloid leukemia is a blood cancer that occurs when your body produces too many white blood cells. […] We use a team approach that combines recommendations from different blood cancer specialists to provide exceptional care. […] We explain tests and treatments in ways you can understand. You are welcome to bring loved ones with you to care appointments. They can help you keep track of important details or remember to ask specific questions. […] We offer testing options and expertise that lead to a timely, accurate diagnosis. Our experience and attention to detail means you can start treatments earlier. […] If you are in the accelerated or blast phase of CML, targeted therapy may help you feel better. This type of cancer drug attacks specific proteins and spares healthy cells so you may experience fewer side effects.
#113 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422
Talk to your health care provider about your side effects. Powerful cancer medicines can cause many side effects. […] Don’t stop treatment on your own. […] Ask for help if you’re having trouble coping. […] Learn enough about chronic myelogenous leukemia to make decisions about your care. […] Stay connected to friends and family. […] Find someone to talk with.
#114 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Chronic myeloid leukemia is a blood cancer that occurs when your body produces too many white blood cells. […] We use a team approach that combines recommendations from different blood cancer specialists to provide exceptional care. […] We explain tests and treatments in ways you can understand. You are welcome to bring loved ones with you to care appointments. They can help you keep track of important details or remember to ask specific questions. […] We offer testing options and expertise that lead to a timely, accurate diagnosis. Our experience and attention to detail means you can start treatments earlier. […] If you are in the accelerated or blast phase of CML, targeted therapy may help you feel better. This type of cancer drug attacks specific proteins and spares healthy cells so you may experience fewer side effects.
#115 Chronic Myeloid Leukemia | Mays Cancer Center
https://cancer.uthscsa.edu/cancer-care/types-and-treatments/chronic-myeloid-leukemia
Chronic myeloid leukemia is a blood cancer that occurs when your body produces too many white blood cells. […] We use a team approach that combines recommendations from different blood cancer specialists to provide exceptional care. […] We explain tests and treatments in ways you can understand. You are welcome to bring loved ones with you to care appointments. They can help you keep track of important details or remember to ask specific questions. […] We offer testing options and expertise that lead to a timely, accurate diagnosis. Our experience and attention to detail means you can start treatments earlier. […] If you are in the accelerated or blast phase of CML, targeted therapy may help you feel better. This type of cancer drug attacks specific proteins and spares healthy cells so you may experience fewer side effects.
#116 Leukemia: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/leukemia/?srsltid=AfmBOorXR9ChCk2wB-pEQWTbdGUXZ68wHABvM53RDMbOVD31a8FTVYY8
Patient will remain free of infection and bleeding complications […] Fatigue will be managed effectively with appropriate interventions […] Patient will demonstrate understanding of leukemia and its treatment, including potential side effects […] Patient will develop coping strategies to manage the emotional and physical challenges of leukemia. […] Educate the patient and family about the importance of infection prevention and how to recognize signs of infection, such as fever. […] Discuss potential side effects of chemotherapy and targeted therapies, including nausea, hair loss, and increased risk of bleeding. […] Provide information about stem cell transplantation, if applicable, including the process and potential complications. […] Encourage caregivers to provide emotional support and help manage the patients day-to-day needs, including transportation to treatments and ensuring medication adherence.
#117 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
In this article, we will discuss leukemia nursing care plans and nursing diagnosis that nurses can use to provide effective care for their patients. We will provide a detailed explanation of each plan and diagnosis, as well as tips for implementing effective nursing interventions. […] The nursing management and care plan for patients with leukemia involve several important aspects. Nurses play a crucial role in assessing and monitoring patients, managing symptoms, and providing support throughout the treatment journey. […] The following are the nursing priorities for patients with leukemia: Minimizing infection through infection control, Managing side effects of chemotherapy, Managing pain, Providing emotional support, Providing health teachings. […] Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with leukemia based on the nurses clinical judgement and understanding of the patients unique health condition.
#118 8 Leukemia Nursing Care Plans – Nurseslabs
https://nurseslabs.com/leukemia-nursing-care-plans/
In this article, we will discuss leukemia nursing care plans and nursing diagnosis that nurses can use to provide effective care for their patients. We will provide a detailed explanation of each plan and diagnosis, as well as tips for implementing effective nursing interventions. […] The nursing management and care plan for patients with leukemia involve several important aspects. Nurses play a crucial role in assessing and monitoring patients, managing symptoms, and providing support throughout the treatment journey. […] The following are the nursing priorities for patients with leukemia: Minimizing infection through infection control, Managing side effects of chemotherapy, Managing pain, Providing emotional support, Providing health teachings. […] Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with leukemia based on the nurses clinical judgement and understanding of the patients unique health condition.
#119 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis
https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml
Chronic myeloid leukemia (CML) is blood cancer that starts in the blood-forming myeloid cells or stem cells in your bone marrow. Healthcare providers treat CML with innovative therapies that have turned CML from being a potentially life-threatening illness into a chronic illness. […] Many people with CML may have normal life spans, thanks to therapy that has turned the condition from a life-threatening illness into a chronic illness that medication can manage. […] Prompt treatment keeps CML from getting worse. Without treatment, chronic myeloid leukemia can become a life-threatening illness within three to four years. […] Healthcare providers typically treat chronic phase CML with tyrosine kinase inhibitors (TKIs). TKIs are a type of targeted therapy. In CML, the targets are the abnormal BCR-ABL enzymes that let abnormal white blood cells divide and multiply uncontrollably. TKIs block the enzymes so that CML cells start to die.
#120 Patient Empowerment in the Management of Chronic Myeloid Leukemia | Oncology Nursing Society
https://www.ons.org/cjon/18/2/patient-empowerment-management-chronic-myeloid-leukemia
Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients’ innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. […] Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. […] In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.
#121 Clinical pathway for patients with Chronic Myeloid Leukaemia: The Euriclea Project
https://pmc.ncbi.nlm.nih.gov/articles/PMC6357587/
To implement the integrated care pathway of which the CMN is a facilitator, it is imperative to create a collaborative network between this figure and all professionals, services and Care Givers (CGs) involved in the clinical pathway. […] Adherence to therapy with TKIs should be strictly monitored during the treatment period. […] The side effects, although mild, when persistent can become intolerable for the patient. […] The effectiveness and sustainability of CML care processes should be measured and evaluated through the use of specific indicators. […] Adequate structures and dedicated nurse figure, such as Case Manager, able to approaching patients in a preventive, change-oriented, dynamic and flexible manner, would seems to be the best response to the patients problems.