PART I

PRELIMINARY

A. BACKGROUND

Leukemia is a malignant disease that is derived from hematopoietic stem cell system
that results in the proliferation of white blood cells is not controlled and the red blood cells,
but very rarely. The disease is caused by damage to the blood cell manufacturer that the bone
marrow to work actively making blood cells but produced is abnormal blood cells and these
cells urgent growth of normal blood cells.

B. PROBLEM FORMULATION

1. How does the concept of leukemia?

2. How is the management of patients with cases of leukemia?

C. OBJECTIVES

1. The general objective of the student is able to understand the concept of leukemia
Special Purpose

2. Students are able to explain the definition of leukemia.

3. Students are able to explain the etiology of leukemia.

4. Students are able to explain the signs and symptoms of leukemia. Students are able to
explain management.

5. Students are able to explain management.

 CHAPTER II

DISCUSSION

A. DEFINITIONS

This disease is a pathological proliferation of blood making cells which are systemic
his usual ended badly. Leukemia said blood disorder caused by damage to the blood cells
manufacturer, ie the sum bone marrow. The disease is often called a blood cancer. The actual
circumstances of bone marrow actively work to make blood cells but produced is abnormal
blood cells and these cells urgent growth of normal blood cells. Based on morphological cell
leukemia there are 5 major categories in accordance with 5 kinds haemopoietic system in
bone marrow. (Ngastiyah, 2005).Five major categories of leukemia:

1. Leukemia erythropoietic system: mielosis eritremika or disease in guglielmo.

2. Leukemia system granulopoietik: granulocytic or myelocytic leukemia.

3. Leukemia system trobopoietik: megakariositik leukemia.

4. Leukemia system limfopoietik: lymphocytic leukemia.

5. Leukemia RES: Retikuloendoteliosis which may include monocytic leukemia,

leukemia plasmositik (Kahler's disease), histiocytosis, and so forth.

Symptoms generally klisnis of various leukemia almost the same just different whether acute
or chronic. Also other hematological symptoms that depend on morphological cell.

Differences normal blood with the blood of leukemia

B. ETIOLOGY
 Definite etiology of leukemia is not known. Leukemia, like other cancers, occurs
because of somatic mutations in the DNA which activate oncogenesis or deactivate tumor
suppressor genes, and disrupt the regulation of cell death, differentiation or divisi.Tapi studies
have been able to present a risk factor of this leukemia, among others:

1. The level of radiation is high people - people who are exposed to high levels of
radiation are more susceptible to leukemia compared with those not exposed to
radiation. High levels of radiation can occur due to the explosion of the atomic bomb
as happened in Japan. Treatment using radiation could be a source of high radiation
exposure.

2. People who work with materials - certain chemicals are exposed to benzene at high
levels of benzene in the workplace can cause leukemia. Benzene is used widely in the
chemical industry. Formaldehyde is also used extensively in the chemical industry,
workers exposed to formaldehyde had a greater risk of leukemia.

3. Chemotherapy patients with cancer who are treated with anti-cancer drugs sometimes
- sometimes develop into leukemia. For example, the drug known as an agent
associated with the development of leukemia alkilating end - the end.

4. Down Syndrome and other genetic diseases are caused by several diseases of
abnormal chromosomes may increase the risk of leukemia.

5. Human T-cell leukemia virus-I (HTVL-I) This virus causes a rare type of chronic
lymphocytic leukemia yangdikenal as a T-cell leukemia.

6. Myelodysplastic syndrome people - people with this blood disease have a risk of
developing acute myeloid leukemia.

7. Fanconi Anemia causes acute myeloid leukemia

C. SIGNS AND SYMPTOMS

1. Acute myeloblastic leukemia

a. Weakness, pale, loss of appetite
b. Anemia
c. Bleeding, petechiae
d. bone pain
e. Infection
f. Enlarged lymph nodes, spleen, liver and lymph mediatinum
g. Sometimes - sometimes found gum hypertrophy, especially on the M4 and M5
h. Headache

2. Chronic myeloblastic leukemia

a. Fatigue
b. Weight loss
 c. Full feeling in the stomach
d. Sometimes - sometimes a pain in the stomach
e. Bleed easily
f. increased diaphoresis
g. Can not stand the heat

3. Acute lymphocytic leukemia

a. Malaise, fever, lethargy, convulsions
b. Night sweats
c. Hepatosplenomegaly
d. Bone and joint pain
e. Anemia
f. Kind of - kind of infection
g. Weight loss
h. Gag
i. Impaired vision
j. Headache

4. Chronic lymphocytic leukemia

a. Susceptible to infection
b. Anemia
c. Weak
d. Sore - sore
e. Thrombocytopenia
f. Depressed antibody response
g. Synthesis immonuglobin not enough
D. MANAGEMENT

1. Blood transfusion, his usual given if Hb less than 6 g%. In severe thrombocytopenia
and bleeding massif, can be given a transfusion of platelets and if there are signs of
DIC can be given heparin.

2. Corticosteroids (prednisone, cortisone, dexamethasone, and so on). Having achieved

remission dose gradually reduced and finally stopped.

3. sitostatika. Sitostatika generally given in combination together in such together with

predison. In this administration are often found side effects such as alopecia (balding),
stomatitis, leukopenia, secondary infection or candidiasis.

4. Secondary infections avoided (better patient treated in a sterile room).

5. Immunotherapy, is the latest method of treatment. Having achieved remission and the
leukemia cell count is low enough (105-106).

Getting treatment vary depending on each clinical experience, but the principle is the
same, namely the conscious patterns:

a. Induction. Meant to achieve remission with various drugs to blast cells in the bone
marrow is less than 5%.

b. Consolidation. Aiming for the cells to multiply rapidly yangersisa not anymore.

c. Rumat. To maintain remission for longer. Usually by giving sitostatika half the usual
dose.

d. Reinduksi. Intended to prevent the relaxation is usually done every 3-4 months by
administering drugs such as on induction for 10-14 days.

e. Preventing the occurrence of leukemia in the central nervous system given by

intrathecal methotrexate and cranial radiation.

f. Immunologic treatment.

EXAMPLES OF LEUKEMIA PATIENTS:

 CHAPTER III

COVER

A. CONCLUSION

Leukemia is a type of blood cancer. This disorder is caused by white blood olehsel
produced exceeds the amount that should have been there. Leukemia is composed of two
major types, namely acute lymphoblastic leukemia and acute myeloid leukemia. Number of
patients with acute lymphoblastic leukemia is generally more than other types of acute
myeloid leukemia. The main cause blood disorders disease is as yet known with certainty,
and it is still under investigation. However, genetic factors play a role quite important in some
research done.

Therapy was administered in patients with acute leukemia aims to destroy the
leukemia cells and restore blood cells are normal. Therapies used are usually chemotherapy
(the administration of drugs through an IV), drugs, or radiation therapy. For certain cases, it
can also be done with bone marrow transplant behind. Regarding the possibility of
therapeutic success, so depending on when the first discovery of the disease of the patient.
Whether in the early stages or sudahlanjut, disease subtype, whether regular therapy schedule
performed, arising Relapse (recurrence) or during therapy and possible causes that could be
expected.

B. RECOMMENDATION

For families should understand how the therapeutic management of patients with
leukemia that the disease is not entered an advanced stage.
 BIBLIOGRAPHY

Ngastiyah. (2005). Perawatan anak sakit. (ed 2). Jakarta : EGC.

Saripudin. Yuliani, R. (2010). Asuhan keperawatan pada anak (Ed. 2nd). Jakarta : CV. Sagung
Seto.
Hidayat, alimul azis. (2006). Pengantar ilmu keperawatan anak. Jakarta: Salemba Medika