A client newly diagnosed with leukemia is experiencing bone pain and tenderness. What is the underlying cause of these symptoms?

A) This choice is incorrect because there is no strong evidence to support smoking as a major risk factor for leukemia. Smoking is primarily associated with lung cancer and other respiratory conditions.

B) This choice is incorrect because while smoking is associated with other types of cancer, such as lung, throat, and mouth cancers, it is not definitively linked to leukemia.

C) This choice is incorrect because while smoking can increase the risk of certain cancers, its link to leukemia remains uncertain. Research on this topic has not provided conclusive evidence of a significant association between smoking and leukemia development.

D) This choice is correct. The link between smoking and leukemia is still uncertain and not well-established. While smoking is a known risk factor for several types of cancer, its specific role in leukemia development requires further study.

A) This choice is incorrect because CLL specifically involves the overproduction of abnormal lymphocytes, not myeloid cells. Myeloid cells are affected in other types of leukemia, such as AML.

B) This choice is incorrect because CLL is a chronic and indolent type of leukemia. It has a slow onset and progresses slowly over time, unlike some other leukemias that may have a more rapid course.

C) This choice is correct. In CLL, abnormal lymphocytes, mainly B-lymphocytes, accumulate in the bone marrow and interfere with the production of other blood cells, including red blood cells, platelets, and other white blood cells.

D) This choice is incorrect because CLL does not involve a genetic mutation leading to uncontrolled growth of red blood cells. That description is more characteristic of polycythemia vera, a different type of blood disorder.