Each child develops a unique pattern of blood counts during treatment, and some parents like to track the changes. You can put lab sheets in a binder or enter blood test results in a computer program that shows trends over time. Doctors consider all of the laboratory results before deciding on a course of action. They should be willing to explain their plan so you can better understand what is happening and worry less.
If your child is participating in a clinical trial and you have obtained the entire clinical trial protocol (discussed in Chapter 5, Choosing a Treatment), it will contain a section that clearly outlines the actions that should be taken by the neuro-oncologist if certain changes in blood counts occur. For example, most protocols list each drug and when the dosage should be modified. The following is an example from a protocol for the drug vincristine.
1.5 mg/m2 (2 mg maximum) IV push weekly x 4 doses days 0, 7, 14, 21.
Hold one dose, then reinstitute.
Severe foot drop, paresis, or ilius
Hold dose(s): when symptoms abate, resume at 1.0 mg/m2; escalate to full dose as tolerated.
Treat with analgesics; do not modify vincristine dose.
Withhold if total bilirubin is >1.9 mg/dL.
Administer ½ dose if total bilirubin is 1.5–1.9 mg/ dL.
Table of ContentsAll Guides
- 1. Diagnosis
- 2. The Brain and Spinal Cord
- 3. Types of Tumors
- 4. Telling Your Child and Others
- 5. Choosing a Treatment
- 6. Coping with Procedures
- 7. Forming a Partnership with the Treatment Team
- 8. Hospitalization
- 9. Venous Catheters
- 10. Surgery
- 11. Chemotherapy
- 12. Common Side Effects of Chemotherapy
- 13. Radiation Therapy
- 14. Peripheral Blood Stem Cell Transplantation
- 15. Siblings
- 16. Family and Friends
- 17. Communication and Behavior
- 18. School
- 19. Sources of Support
- 20. Nutrition
- 21. Medical and Financial Record-keeping
- 22. End of Treatment and Beyond
- 23. Recurrence
- 24. Death and Bereavement
- 25. Looking Forward
- Appendix A. Blood Tests and What They Mean
- Appendix C. Books and Websites