Description of the Disease, Its Prevalence, and Incidence
Acute lymphoblastic leukemia (ALL) is an uncommon type of cancer that attacks blood’s white cells in the bone marrow. The disease begins with immature cells and progresses rapidly, so the keyword acute is included in the label. Terwilliger and Abdul-Hay (2017) hypothesize that this illness is caused by aberrant lymphoid cell growth and division on a global scale. Therefore, it can manifest itself in more severe symptoms such as convulsions, nausea, and headaches. While there is no definitive explanation for why mutations occur, known risk factors include smoking, being overweight, a compromised immune system, and past rounds of chemotherapy. Terwilliger and Abdul-Hay (2017) estimate that the prevalence of ALL in the United States is 1.6 per 100,000 population. According to the study, in 2016, medical practitioners diagnosed 6590 incidences of the illness and identified 1400 fatalities (Terwilliger & Abdul-Hay, 2017).
Discussion of Possible Laboratory Testing
Laboratory testing is a critical aspect in determining whether a clinician can appropriately assess a client’s condition. A medical professional may order a series of assessments to diagnose acute lymphoblastic leukemia, comprising blood, bone marrow, and imaging techniques. A complete blood count is used to determine the precise number of each blood cell type in an individual, whereas a peripheral blood smear is used to determine alteration in the appearance and mobility of blood cells. By examining a bone marrow specimen for symptoms of leukemia, bone marrow testing can assist the health care team in progressing with the diagnosis.
Chromosomal Analysis
Chromosome analysis, also known as karyotyping, is recommended in the treatment ALL. The key reason for its requirement is that it enables physicians to discover chromosomal abnormalities. Both comprehensive information and investigation of these anomalies are required for ALL diagnoses. No test processing is required before the operation, typically conducted only if a pregnancy diagnostic test fails or if symptoms are consistent with a condition caused by a chromosomal disorder. According to the American Cancer Society (2018), ALL is caused by chromosomal abnormalities, the most frequent of which is the Philadelphia chromosome. Additionally, ALL may be caused by chromosome translocations such as abnormalities between chromosomes 4 and 11, 8 and 14, and deletions and rearrangements.
Disorder Origin: Considerations for Practice and Patient Education
To gain a complete understanding of ALL, it is necessary to examine its probable etiologies. Jimenez-Morales et al. (2017) observe a Mendelian heritability in select ALL cases. Additionally, this form of cancer should be considered multifunctional, implying a complicated genetic architecture. The architecture where mutations in low-penetrance genes take part in DNA repair, xenobiotic sensitivity, immune system, and regulatory genes contribute to disease progression (Jimenez-Morales et al., 2017). Therefore, this is the disorder’s root, and it is critical to research its origins, comorbidities, manifestations, treatment options, and prognoses extensively. Concerning practical considerations, the key attention should be on the reality that ALL mostly affects children. Thus, physicians must maintain continual touch with family members regarding any healthcare choices. After analyzing a health history and doing comprehensive interviews with guardians, a clinician can raise alarms about the likelihood of gene abnormalities causing ALL.
Gene Mutation of the Disease
Certain individuals get a specific kind of cancer due to DNA alterations inherited from their guardians, significantly increasing their risk of becoming ill. However, this is not a common occurrence in acute lymphoblastic leukemia. Hereditary abnormalities are a problem only in individuals with pre-existing genetic disorders indicated as potentially acquiring ALL. However, biologists now realize that the condition arises from repeated genetic alterations that impair preceding B- and T-cell development while accelerating cell growth. As a result, cancerous, immature lymphoid cells cluster in the bone marrow and peripheral circulation.
How Genetics Can Influence Policy Issues
Genetics has developed into one of the most intriguing and forward-thinking fields of medical research. Nevertheless, for biologists to extend the frontiers of what is understood and search for the genetic link of illnesses, large amounts of information must be collected and analyzed. This information is critical for researchers to investigate the incidence and extent of genetic risk factors, estimate the death rates associated with genetically linked illnesses, and analyze the usefulness of genetic screening techniques (Wright Glayton et al., 2019). As a result, numerous legislative difficulties arise, most notably due to public sensitivity to genetic education and healthcare information protection. Although certain standards are in place to ensure the greatest transparency conceivable in genetic monitoring and experimentation, they contain numerous loopholes (Wright Glayton et al., 2019). As a result, several authorities have prioritized resolving growing concerns and further restricting the administration’s and private enterprises’ accessibility to personal health information.
Nutritional Influences for the Cause of Acute Lymphoblastic Leukemia
ALL is caused by genetic alterations in an individual’s bone marrow cells. As a result, oncogenes are activated in the DNA of the bone marrow cell when a person is diagnosed with ALL, while tumor suppressor genes are silenced. While nutritional effects are not separate, specific considerations must be made. Slayton et al. (2020) speculate that prenatal toxic compounds and radiation may play a role in ALL. As a result, if a mother consumes foods polluted with high radioactive contamination or harmful chemicals during pregnancy, her child is more likely to acquire genetic abnormalities such as those that cause ALL.
The Process of Nutritional Assessment as It Relates to Health, Prevention, Screening, Diagnostics, Prognostics, etc.
Malnutrition is a significant problem for pediatric patients since it affects the patient’s care and its usefulness. Additionally, a well-balanced change in diet is an incredibly effective tool for alleviating clinical manifestations and eliminating the adverse effects of prescription medications. A nutritional examination and particular dietary recommendations can help reduce the likelihood of newborns developing genetic abnormalities in pregnant women. Healthy examinations are critical for people living with cancer, as they are at a higher risk of malnutrition. The anthropometric and dietary tests can provide adequate information for the care professional to establish a nutritional intrusion tailored to the individual’s present health condition, diagnosis, and long-term outlook.
Ethical Considerations of Acute Lymphoblastic Leukemia (ALL)
A medical ethics organization seeks to clarify ethical difficulties that arise throughout patient care. Individual ethicists and representatives of ethics committees should have training in various fields, including moral judgment, medical ethics, health legislation and regulation, and interpersonal interactions (Miladinia et al., 2017). This ethical imperative requires ALL patients’ needs to take precedence above the caretakers’, clinicians’, and societal concerns, responsibilities, and expectations (Miladinia et al., 2017). Acknowledging the ethical environment concerning leukemia medication will better equip practitioners with quality standards for navigating ethical problems and enhancing patient care.
How Genetics Can Improve Care and Health Outcomes while Reducing Cost to usual Practices
Over the last few years, much attention has been paid to the promise of genetic medicine, with predictions that genomes will soon drive the detection, identification, and management of human diseases. However, this transformation has been considerably slower, even in areas where the data is frequently compelling, such as pharmacogenomics. There are several reasons for this, including the demand for economic assets and the necessity for the will to overcome impediments inhibiting healthcare reform.
When things get complicated or costly, using a gradual approach may be the best course of action. Individualizing treatment for ALL is both successful and inexpensive for ALL individuals. Genomics has been critical in increasing ALL treatment efficacy over the last 25 years and has the potential to fundamentally alter the character of ALL management (Perdana et al., 2020). Furthermore, genomics will focus more on drugs and testing that dictate each individual’s administration and sequence of therapies over the next decade
Changes in Approaches to Care when New Evidence Warrants Evaluation of other Options for Improving Outcomes or Decreasing Adverse Events
When children and adolescents with ALL are administered customized pediatric treatment regimens, they may have successful productivity. The introduction of new T-cell-based medication as a therapeutic approach for ALL highlights the importance of improving medical decisions for patients with recurrent B-cell lymphoma (Follini et al., 2019). T-cells are extracted from individuals with refractory B-cell ALL and genetically engineered with the 19-28z chimeric antigen-binding site design (Follini et al., 2019). The antigen binding site comprises a CD19-binding protein connected to the transduction elements of the CD28 costimulatory interface and the CD3 multifaceted ζ-chain. With this new approach to care, the treatment outcomes of ALL patients are improved.
Plan for Educating Colleagues and Patients on this Disorder
Individuals with ALL should be urged to seek medical assistance quickly if they develop a fever or show symptoms of bleeding. Additionally, patients with leukemia receiving treatment should avoid crowds and individuals with communicable diseases, particularly youngsters with infectious diseases. While individuals with ALL may engage in activities as permitted, they may be unable to engage in rigorous tasks such as weightlifting or exercising. Additionally, these persons should adopt a neutropenic regimen as follows: No raw fruits or vegetables are permitted; all foodstuffs must be prepared, and meat must be boiled to a well-done temperature.
References
American Cancer Society. (2018). What causes acute lymphocytic leukemia (ALL)? Cancer.
Follini, E., Marchesini, M., & Roti, G. (2019). Strategies to overcome resistance mechanisms in T-cell acute lymphoblastic leukemia. International Journal of Molecular Sciences, 20(12), 3021.
Jiménez-Morales, S., Hidalgo-Miranda, A., & Ramírez-Bello, J. (2017). Acute lymphoblastic leukemia: A genomic perspective.Boletín Médico Del Hospital Infantil de México (English Edition), 74(1), 13–26.
Miladinia, M., Baraz, S., Shariati, A., & Malehi, A. S. (2017). Effects of slow-stroke back massage on symptom cluster in adult patients with acute leukemia: supportive care in cancer nursing. Cancer Nursing, 40(1), 31-38. Web.
Perdana, A. B., Saputra, F., & Aisyi, M. (2020). Update on Diagnosis of Childhood Acute Lymphoblastic Leukemia (ALL) in Indonesia. Indonesian Journal of Cancer, 14(4), 115-116.
Slayton, W. B., Schultz, K. R., Silverman, L. B., & Hunger, S. P. (2020). How we approach Philadelphia chromosome‐positive acute lymphoblastic leukemia in children and young adults.Pediatric Blood & Cancer, 67(10), e28543.
Terwilliger, T, & Abdul-Hay, M. (2017). Acute lymphoblastic leukemia: A comprehensive review and 2017 update. Blood Cancer Journal, 7(6), e577.
Wright Clayton, E., Evans, B. J., Hazel, J. W., & Rothstein, M. A. (2019). The law of genetic privacy: Applications, implications, and limitations.Journal of Law and the Biosciences, 6(1), 1–36.