We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byImogene Singleton
Modified about 1 year ago
2© Paradigm Publishing, Inc. Chapter 21 Cancer and Chemotherapy
Chapter 21 Topics Pathophysiology of Cancer Malignancy Drugs for Cancer Preparing and Handling Cytotoxic Drugs Preventing Chemotherapy-Related Medication Errors 3© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy About Cancer and Chemotherapy Agents Cancer is the second leading cause of death in the U.S. About 1.5 million people diagnosed with cancer each year 1 out of every 2 people in the U.S. will develop cancer Medications to treat cancer (chemotherapy) are complex Narrow window between safe use and toxicity Chemotherapy administered in a hospital or outpatient chemotherapy infusion center by IV Technicians prepare most of these drugs Oral chemotherapy is expanding patient care into community practice 4© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy About Cancer Cancer is a group of diseases characterized by the uncontrolled growth of dysfunctional cells Two major classes of the genes in the cancer process: oncogenes and tumor-suppressor genes Oncogenes promote cancer formation Tumor-suppressor genes turn off or downregulate the proliferation of cancer cells All cells, including oncogenes, develop from proto- oncogenes (code for growth factors or their receptors) 5© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy About Cancer (continued) Alterations of proto-oncogenes can activate the oncogenes that promote abnormal cell growth Activation can occur via exposure to chemicals, viruses, radiation, or hereditary factors Example: erb-B2 (or HER-2neu); codes for a growth factor receptor found in some breast cancers Mutations or deletions of tumor-suppressor genes can also result in uncontrolled cell growth Example: The normal gene product of p53 induces apoptosis (cell death) in abnormal or aging cells 6© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy Cell Proliferation and Gompertzian Kinetics Mathematical model to show an approximation of tumor cell proliferation Early cancer growth is exponential Takes about 30 divisions of cells to make 1 gram (about 1 cm 3 ) of tumor mass This is the smallest clinically detectable tumor At this stage, tumor is most sensitive to chemotherapy agents that attack and destroy rapidly dividing cells 7© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy Cell Proliferation and Gompertzian Kinetics (continued) A lethal tumor burden (size) is 1 kg mass (about 10 12 cells) Tumor burden relates to chemotherapy response The smaller the tumor burden, the more effective chemotherapy will be Cell-kill hypothesis: each cycle of chemotherapy kills a certain percentage of cancer cells Tumor cell count never reaches zero from treatment When number of cancer cells is low enough, normal defense mechanisms take over and kill remaining cells 8© Paradigm Publishing, Inc.
Pathophysiology of Cancer and Malignancy © Paradigm Publishing, Inc.9 Tumor Cell Growth A tumor must reach a certain size before it can be detected Chemotherapy drugs can kill only a percentage of cancer cells after this point
Drugs for Cancer About Chemotherapy Chemotherapy is the use of drugs to treat disease; the term most often refers to drugs used to treat cancer Chemotherapy drugs are cytotoxic drugs (toxic to cells), hormonal therapies, or targeted therapies for cancer Multiple factors affect tumor response to chemotherapy Tumor size (tumor burden), cell resistance to the drug, amount of chemotherapy given, condition of patient Chemotherapy is usually given in combination regimens Combination chemotherapy maximizes effectiveness of regimen while minimizing toxicity and resistance 10© Paradigm Publishing, Inc.
Drugs for Cancer © Paradigm Publishing, Inc.11 The Cell Cycle and Use of Multiple Drugs Multiple agents are often used to act on phases of the cell cycle to increase effectiveness and kill more cancer cells
Drugs for Cancer The Cell Cycle The process of division of normal and cancer cells Cancer cells most sensitive to drugs that affect cell cycle Cell cycle–specific chemotherapy regimens administered as continuous infusions or in repeated bolus doses These drugs are schedule-dependent Examples: continuous infusion of fluorouracil or cytarabine; repeated bolus doses of weekly bleomycin Cell cycle–nonspecific drugs work at any point in the cell cycle; these drugs are more dose-dependent Example: cyclophosphamide (alkylating agent) 12© Paradigm Publishing, Inc.
Drugs for Cancer Types of Chemotherapy 13© Paradigm Publishing, Inc.
Drugs for Cancer Traditional Chemotherapy and Cytotoxic Drugs Cytotoxic drugs interfere with some normal process of cell function or proliferation Four categories: alkylating agents (oldest), antimetabolites, topoisomerase inhibitors, antimicrotubule agents See Table 21.1 for a list of cytotoxic drugs in each category and their major side effects Cytotoxic drugs do not target tumor cells specifically; can cause many side effects to normal cell function See Table 21.2 for toxicities of specific chemotherapy drugs and preventive measures to avoid these toxicities 14© Paradigm Publishing, Inc.
Drugs for Cancer © Paradigm Publishing, Inc.15 Common Side Effects of Chemotherapy Drugs Bone marrow suppression (decreased production of blood cells, increased risks of infections and bleeding) Hair loss (alopecia) Nausea and vomiting Mucosal damage to the lining of the mouth and intestinal tract (mucositis) Bone marrow suppression (decreased production of blood cells, increased risks of infections and bleeding) Hair loss (alopecia) Nausea and vomiting Mucosal damage to the lining of the mouth and intestinal tract (mucositis)
Your Turn Question 1: What is the purpose of giving chemotherapy in combination regimens? Answer: Combination chemotherapy maximizes effectiveness of the regimen while minimizing toxicity and resistance. Question 2: What is the reason traditional chemotherapy drugs cause a lot of side effects related to normal cell function? Answer: These cytotoxic drugs exert the majority of their effects on cancer cells, but they do not target tumor cells specifically. 16© Paradigm Publishing, Inc.
Drugs for Cancer Alkylating Agents Mechanism of Action: bind to and damage DNA during the cell division process, preventing cell replication Indication: treat a wide variety of cancer types Side Effects (common): bone marrow suppression, infertility, nausea, vomiting, hair loss Side Effects (rare, severe): secondary cancers (mutagenic) Cautions (cisplatin): renal damage, depletion of potassium and magnesium, peripheral neuropathy, ototoxicity Cautions (ifosfamide): hemorrhagic cystitis; can be prevented if co-administered with mesna 17© Paradigm Publishing, Inc.
Drugs for Cancer Antimetabolites Mechanism of Action: work in the synthesis phase of the cell cycle by a variety of different mechanisms Some inhibit enzyme activity needed for DNA/RNA synthesis; others interfere with enzymes needed for tumor proliferation; still others act as false nucleotides Indication: variety of tumors (see Tables 21.3 and 21.4) Side Effects (common): bone marrow suppression, immune system suppression, mucositis Side Effects (capecitabine): hand-foot syndrome Side Effects (cytarabine): conjunctivitis 18© Paradigm Publishing, Inc.
Drugs for Cancer Antimetabolites (continued) Methotrexate Indication: leukemias, bone cancer, breast cancer, lymphomas Complicated to administer; very wide range of doses Can cause serious toxicities such as kidney damage IV fluids are given to alkalinize (increase pH of) urine to avoid formation of damaging crystals in kidneys Can cause severe bone marrow suppression, mucosal injury in the intestinal tract Prevent by administering leucovorin (folinic acid) 19© Paradigm Publishing, Inc.
Drugs for Cancer Topoisomerase Inhibitors Mechanism of Action: interfere with DNA repair function of topoisomerases and disrupt the cell replication process Indications: very important in the treatment of many different types of cancer (see Tables 21.3 and 21.4) Side Effects (common): bone marrow suppression, mucositis, nausea and vomiting, alopecia Topoisomerase I inhibitors include topotecan (ovarian and lung cancers) and irinotecan (lung and colon cancers) Side Effect (irinotecan): severe diarrhea; managed with injectable atropine (an anticholinergic) 20© Paradigm Publishing, Inc.
Drugs for Cancer Topoisomerase Inhibitors: Anthracyclines Mechanism of Action: inhibit topoisomerase activity by inserting themselves (or intercalating) into DNA strands Indication (doxorubicin): breast cancer and lymphomas Indication (epirubicin): breast, stomach, esophageal cancer Indication (daunorubicin and idarubicin): leukemia Side Effect (most serious, all): cardiac toxicity; typically occurs many years after patients have received drug Caution (all): extravasation (drugs are called vesicants) Some anthracyclines are in liposomal products to decrease toxicity 21© Paradigm Publishing, Inc.
Drugs for Cancer © Paradigm Publishing, Inc.22 Chemotherapy Vesicant Drugs Daunorubicin Doxorubicin Epirubicin Idarubicin Mechlorethamine Mitomycin Vinblastine Vincristine Vinorelbine Daunorubicin Doxorubicin Epirubicin Idarubicin Mechlorethamine Mitomycin Vinblastine Vincristine Vinorelbine
Drugs for Cancer Antimicrotubule Agents Mechanism of Action: interfere with the formation and function of microtubules; prevent cell growth and division Most antimicrotubules are derived from plant sources The vinca alkaloids are derived from periwinkle plants The taxanes are derived from yew trees Indications: lung, breast, ovarian, prostate, and testicular cancers; leukemia; lymphoma Side Effects (paclitaxel, docetaxel): allergic reactions during administration (can premedicate to avoid) Side Effects (all): peripheral neuropathy 23© Paradigm Publishing, Inc.
Drugs for Cancer Miscellaneous Cytotoxic Drugs: Bleomycin Mechanism of Action: causes cuts or breaks in DNA strands, preventing the process of cell proliferation Indications: testicular cancer, Hodgkin’s disease Side Effect: pulmonary fibrosis (deadly lung toxicity); however, does not cause bone marrow suppression Miscellaneous Cytotoxic Drugs: Asparaginase Indication: acute lymphocytic leukemia in children Mechanism of Action: breaks down asparagine, depriving leukemia cells of this essential amino acid Side Effect: possible allergic reaction; can switch types 24© Paradigm Publishing, Inc.
Drugs for Cancer Hormonal Drug Therapies Some types of cancer depend on naturally occurring hormones for growth Estrogen and progesterone often stimulate breast tumors Prostate cancer often depends on testosterone for growth Antiestrogens are often used to treat breast cancer Tamoxifen, anastrazole, letrozole, exemestane Antiandrogens, such as bicalutamide and flutamide, are used to treat prostate cancer 25© Paradigm Publishing, Inc.
Drugs for Cancer Hormonal Drug Therapies (continued) LHRH stimulates the production of both male and female reproductive hormones Over time, continuous exposure to LHRH shuts down production of sex hormones Leuprolide (Lupron) and goserelin (Zoladex) are analogs of naturally occurring LHRH Indication: hormone-sensitive tumors, such as breast and prostate cancers Mechanism of Action: eliminates source of endogenous estrogen, progesterone, and testosterone production 26© Paradigm Publishing, Inc.
Drugs for Cancer Targeted Drug Therapies Therapies are directed at specific molecular entities required for tumor cell development, proliferation, growth They exert fewer effects on normal cells; usually much better tolerated than traditional cytotoxic drugs Many signal transduction inhibitors affect the molecular abnormalities associated with specific tumor types Indication (imatinib and dasatinib): CML Monoclonal antibodies target markers on tumor cells Indication (trastuzumab): breast cancer Indication (rituximab): non-Hodgkin’s lymphoma 27© Paradigm Publishing, Inc.
Drugs for Cancer © Paradigm Publishing, Inc.28
Drugs for Cancer © Paradigm Publishing, Inc.29
Drugs for Cancer Targeted Drug Therapies (continued) Some targeted therapies have narrow therapeutic application; many agents target a wider variety of cancers Bevacizumab, an angiogenesis inhibitor, treats breast, lung, colon, and brain cancers Also enhances the effects of cytotoxic drugs when co- administered Cetuximab, a monoclonal antibody, treats head, neck, colon, lung, and pancreatic cancers 30© Paradigm Publishing, Inc.
Drugs for Cancer Targeted Drug Therapies: Side Effects Targeted therapies are usually much better tolerated than are traditional cytotoxic drugs They can cause acne-like skin reactions Sometimes, the rash is a sign that treatment is working Rash managed with topical creams and antibiotic gels Monoclonal antibodies can cause allergic reactions Premedicating with acetaminophen, diphenhydramine, corticosteroids can prevent infusion reactions Severe: bevacizumab can interfere with blood vessel formation, preventing wound healing 31© Paradigm Publishing, Inc.
Drugs for Cancer Targeted Drug Therapies: Side Effects (continued) Severe: bevacizumab can cause bleeding, high blood pressure, and kidney damage Targeted Drug Therapies: The Future Typically provide much more direct treatment for cancer Fewer side effects than traditional cytotoxic drugs 32© Paradigm Publishing, Inc.
Your Turn Question 1: What has caused drug companies to manufacture some anthracycline drugs in lipid formulations? Answer: Anthracyclines can cause severe tissue damage if extravasation occurs (the infusion leaks under the skin during administration). Liposomal products help decrease toxicity. Question 2: Targeted drug therapies offer newer and smarter approaches for chemotherapy treatment. How is this done? Answer: These agents target specific molecular entities required for tumor cell development, proliferation, and growth. By targeting specific features of tumor cells, these therapies exert fewer effects on normal cells and are usually much better tolerated than traditional cytotoxic drugs. 33© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Required Precautions Long-term exposure to cytotoxic drugs require precautions in handling, preparation, and administration Compounding of oral or injectable hazardous drugs must be done in either a Class II BSC or a CACI It is crucial to adhere to strict aseptic and negative pressure techniques as well as wearing PPE The CSTD vial-transfer system allows no venting or exposure of hazardous substances to the environment It is used inside a BSC or a CACI 34© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Required Precautions (continued) Dispose of all unused hazardous drugs as bulk chemotherapy waste; requires special handling See the ASHP Web site for Guidelines on Handling Hazardous Drugs Personal Protective Equipment (PPE) Always use PPE when handling oral and injectable hazardous drugs Includes: gloves, gowns, shoe and hair covers, respirator, safety goggles or glasses 35© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Personal Protective Equipment (PPE) (continued) Use PPE when Performing inventory control measures, such as unpacking a drug order Assembling hazardous drugs for compounding Compounding or cleaning up hazardous drugs Cleaning up spills inside or outside a BSC or a CACI Discard all PPE as chemotherapy waste 36© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Aseptic and Negative Pressure Techniques Use proper aseptic technique when compounding any IV preparation Use a BSC or a CACI with a vertical airflow hood when compounding hazardous preparations Use a slight negative pressure (vacuum inside the vial) to prevent spraying or leaking 37© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Handling Spills/Exposures Clean up small accidental spills to reduce exposure to hazardous drugs Accidental exposure to hazardous drugs inhalation, ingestion, injection, topical absorption (skin, eyes) Spill kits should be available in all areas where hazardous drugs are prepared, administered, or transported MSDS best source for information about hazardous drugs Available from manufacturers; keep in pharmacies 38© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Special Preparations Many hazardous drugs require special handling during preparation or administration Have sensitivity to light (cisplatin, doxorubicin) Need refrigeration to maintain stability (busulfan, dacarbazine) Require special equipment due to issues with plastic (etoposide, paclitaxel, carmustine) Require filters in the infusion tubing (paclitaxel) Follow procedures for compatibility and precipitation of drugs (etoposide, fluorouracil) 39© Paradigm Publishing, Inc.
Preparing and Handling Cytotoxic Drugs Special Preparations (continued) Use correct diluent for reconstitution and final dilution Follow the same rules for PPE that apply to IV product compounding that apply to oral product compounding Follow special precautions for preparations of IT hazardous drugs via lumbar puncture into Ommaya reservoir Delivers chemotherapy directly into CSF Includes: methotrexate, cytarabine, hydrocortisone Do not use preservatives in drug or diluent Use special precautions so drugs for IV administration are not confused with drugs for IT administration 40© Paradigm Publishing, Inc.
Preventing Chemotherapy-Related Medication Errors Role of Pharmacy Technicians Are responsible for drug inventory and medication storage Should implement measures to prevent drug and product mix-ups, especially in SALAD Do not store SALADs next to each other Apply sound-alike/look-alike stickers (e.g., for doxorubicin and liposomal doxorubicin [Doxil]) Use colored and/or lidded storage bins Notice tall-man lettering on labels (CISplatin vs. CARBOplatin, vinCRIStine vs. vinBLAStine) Differing parts of two similar words in capital letters 41© Paradigm Publishing, Inc.
Preventing Chemotherapy-Related Medication Errors Role of Pharmacy Technicians (continued) Prevent errors in calculations: double-check every calculation and verify the correct drug concentration Prevent errors in pharmacist order entry: compare final product label to the original physician order Verify drug, dose, administration schedule, route, and duration of therapy Prevent errors in dosing: ensure adherence to specific manufacturer-provided drug warnings 42© Paradigm Publishing, Inc.
Preventing Chemotherapy-Related Medication Errors Role of Pharmacy Technicians (continued) Prevent errors in administration route Use syringe overwrap from manufacturer for vincristine and vinblastine to indicate that giving these drugs by the IT route is lethal Maintain a clean and organized work environment to avoid chemotherapy medication errors and contamination Ensure that there is no confusion about what is being mixed and which drug and concentration are being used Complete compounding so products meet acceptable standards and are safe 43© Paradigm Publishing, Inc.
Summary Treating cancer involves multiple modalities, such as surgery, radiation, and drug therapy Traditional cytotoxic agents are potent cancer-fighting drugs, but cause a lot of toxicities to normal tissue Targeted therapies are generally safer and better tolerated, but still pose risks for serious side effects Oral cancer treatment expanding into community settings Technicians must follow special precautions in handling, preparation, and administration of cytotoxic drugs 44© Paradigm Publishing, Inc.
Copyright © 2015 Cengage Learning® Chapter 14 Antineoplastic Drugs.
Cancer Chemotherapy Topics 1. Basic principles: cell cycle, tumor growth kinetics, log kill, recruitment, drug targets 2. Mechanisms of drug action 3.
© 2004 by Thomson Delmar Learning, a part of the Thomson Corporation. Fundamentals of Pharmacology for Veterinary Technicians Chapter 20 Antineoplastic.
Clinical Division of Oncology Department of Medicine I Medical University of Vienna, Austria Cytotoxic Agents.
Slide 1 Copyright © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 44 Drugs Affecting Neoplasms.
Cancer Chemotherapy Dr.Azarm. The goal of cancer treatment is eradication of cancer If not possible shifts to palliation,amelioration and preservation.
Microtubule inhibitors. Microtubules Inhibitors Microtubules Inhibitors These drugs disrupt microtubules, which are structures that pull the cell apart.
Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 100 Basic Principles of Cancer Chemotherapy.
Cancer Treatment Ashley Panakezham Rosemin Panjwani Osman Jamal Mustafa Quraishi.
Principles of Chemotherapy. Objectives At the completion of this session the participant will be able to: ◦ Define combination chemotherapy ◦ Recognize.
ABIRA KHAN TUMOR MARKERS & CANCER TREATMENT. TUMOR MARKERS Biological substances synthesized and released by cancer cells or produced by the host in response.
Treatment for Cancer. Surgery Treatment and prognosis depend on severity and spread of the cancer Treatment and prognosis depend on severity and spread.
ONCOLOGY Cytotoxic Agents. ONCOLOGY Cytotoxic agents Selective toxicity based on characteristics that distinguish malignant cells from normal cells Antineoplastic.
CANCER DRUG CLASSES The classes of drugs currently used in the cancer clinic are 1.DNA Binding Agents(intercalating and alkylating agents) 2.Mitotic Spindle.
Cytarabine (araC) Cytidine analogue ALL, AML. thioguanine Guanine analogue AML Watch myelosuppression and GI perforation.
The Cell Cycle and Cancer. Cell signaling: chemical communication between cells. Click on above to go to animation second chemical response inside the.
Chapter 20 Antineoplastic and Immunosuppressive Drugs Copyright © 2011 Delmar, Cengage Learning.
Antineoplastics W hat is Cancer ? Cancer is a disorder of cell division (leading cause of death). C C ancers most commonly occur in: breast (♀) -
ANTINEOPLASTIC DRUGS - MOLECULAR TARGETED AGENTS WEEK-9 MR160 Chapter 29 (p ) Chapter 31 (p )
DEPARTMENT OF PHARMACEUTICS 1. Cancer In most cases, causes of cancer is multifactorial (environmental, genetic) 25% of population of U.S will be diagnosed.
Feb. 17, 2014 Phase II, Foundation BlockAntineoplastics Faculty of Medicine, Kuwait University Prof. Saghir Akhtar RM 327, Phone: 6342
By: Dr. Abdulaziz Bin Saeedan Ph.D. Department of Pharmacology E mail: P harmacology – IV PHL-425 Chapter 2: CANCER CHEMOTHERAPY:
ANTINEOPLASTICS I: GENERAL CONCEPTS. REFERENCES Katzung Basic and Clinical Pharmacology (10th ed.) Chapter 55, pg ESSENTIAL MATERIAL FROM OTHER.
Cancer When cell division goes wrong……. Growing out of control, cancer cells produce malignant tumors Cancer is a general term for many diseases in.
Honors Biology 2016 What is Cancer?. I. What is Cancer? A. Normally, cells are forced to undergo programmed cell death when: DNA is damaged Replication.
Patients on Chemotherapy Dr. Feras FARARJEH. General Concepts The purpose of treating cancer with chemotherapeutic agents is to prevent cancer cells from.
Cancer Medications in the Home Cancer Medications in the Home 1.
BASIS OF CANCER CHEMOTHERAPY PHL 417 Dr. Mohamed M. Sayed-Ahmed.
Cancer therapy - conventional Surgery Radiotherapy Chemotherapy Adjuvant therapies.
Oncology Medications Chemotherapy Agents. Oncology Medications Key Terms Cancer – uncontrolled cell division and growth Malignant – invade other tissues.
Cancer: Uncontrolled Cell Growth How do cancer cells differ from other cells? Cancer cells do not respond to the signals that regulate the growth of most.
Cancer. What does the word cancer mean to you? What is Cancer? Cancer - disease where cells grow out of control and invade, erode and destroy normal.
The Cell Cycle & Cancer What went wrong?!? What is Cancer? Cancer is essentially a failure of cell division control or unrestrained, uncontrolled cell.
Cancer Heather Gates RN, BSN October 20, Core Concepts in Pharmacology, 2e By Norman Holland and Michael Patrick Adams © 2007 Pearson Education,
Antibiotics Classification of Antibiotics: Anthracycline Mitomycin C Bleomycin Actinomycin D Anticancer Agents.
CANCER. Background Cells divide and multiply as the body needs them. Cells divide and multiply as the body needs them. When cells continue multiplying.
Cancer Chemotherapy Prof. Rafi Korenstein Dept. of Physiology and Pharmacology Faculty of Medicine, Tel-Aviv University.
Cancer Therapies DNA microarrays are used to assess the relative expression of thousands of genes simultaneously—relative expression means that.
Regulation of the Cell Cycle. How does a cell know when to divide and when not to divide?
What is cancer? How do cancer cells differ from other cells? Do you know of any types of cancer? If so…name them.
LEARNING GOALS: I CAN… …understand how cancerous (malignant) tumors evolve within the body. …describe different stages in diagnosing cancer. …explain.
Mosby items and derived items © 2007, 2005, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. Pharmacology in Nursing Antineoplastic Drugs Part 1: Cancer.
Therapy of cancer disease This study material is recommended specifically for practical courses from Pharmacology II for students of general medicine and.
Anticancer Drugs. Introduction Cancer refers to a malignant neoplasm or new growth. Cancer cells manifest uncontrolled proliferation, loss of function.
Copyright © 2006 Pearson Education, Inc. publishing as Benjamin Cummings.
PBL 6 – Lymphoma and leukemia. Age bracketing leukemia 0 – – 39 (clue: peripheral blood smear will have blasts with Auer rods) 40 – 59 > 60.
Cancer 101 Monica Schlatter, RN, ND, AOCNP. Types of Cancer AIDS- related malignancies AIDS- related malignancies Bone and soft tissue sarcoma Bone and.
Cancer A class of non-infectious diseases occurring when cell cycle control mechanisms fail. Prefix: Onco.
© 2017 SlidePlayer.com Inc. All rights reserved.