DRG Category: 835

Mean LOS: 9.7 days

Description MEDICAL: Acute Leukemia without Major O. R. Procedure with CC

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Leukemias account for approximately 8% of all human cancers, and approximately half of these cases are classified as acute leukemia. Acute leukemia, a malignant disease of the blood-forming organs, results when white blood cell (WBC) precursors proliferate in the bone marrow and lymphatic tissues. The cells eventually spread to the peripheral blood and all body tissues. Leukemia is considered acute when it has a rapid onset and progression and when, if left untreated, it leads to 100% mortality within days or months.

There are two major forms of acute leukemia: lymphocytic leukemia and nonlymphocytic leukemia. Lymphocytic leukemia involves the lymphocytes (cells derived from the stem cells and that circulate among the blood, lymph nodes, and lymphatic organs) and lymphoid organs; nonlymphocytic leukemia involves hematopoietic stem cells that differentiate into monocytes, granulocytes, red blood cells (RBCs), and platelets. Up to 90% of acute leukemias are a form of lymphocytic leukemia, acute lymphoblastic leukemia (ALL), which is characterized by the abnormal growth of lymphocyte precursors called lymphoblasts. Acute myelogenous leukemia (AML) (also known as acute nonlymphocytic leukemia, or ANLL) causes the rapid accumulation of megakaryocytes (precursors to platelets), monocytes, granulocytes, and RBCs. As the disease progresses, the patient may have central nervous system (CNS) dysfunction with seizures, decreased mental status, or coma and renal insufficiency. Death occurs when the abnormal cells encroach on vital tissues and cause complications and organ dysfunction.

Approximately 45,000 new cases of leukemia occur each year. AML is the most common adult leukemia, and two out of three children who develop acute leukemia develop ALL. Approximately 22,000 adults and children die of all forms of leukemia each year. Patients with AML or ALL can be kept in long-term remission or cured in approximately 20% to 30% of adults. Five-year survival rates for children with ALL are close to 80% and for children with AML close to 40%.