Prior to chemotherapyb During chemotherapyc After chemotherapy completionc, d Diphtheria-tetanus-acellular pertussis Continuation of primary series during lower-intensity phases of therapy (i.e., ALL in maintenance) Continuation of primary series; booster…
Clinical scenario Recommendation Level of evidenceb Treatment of myelosuppression after chemotherapy (primary prophylaxis) Consider if risk of neutropenia is ≥20 % or if patient had neutropenia with previous course of…
Recommendation Grade Comments Reference Data from studies of non-oncology patientsa Data from studies of adult oncology patientsa Data from studies of pediatric oncology patientsa Antibacterial prophylaxis with a fluoroquinolone should…
Clinical scenario Recommendations Level of evidencea SVCS/SMS Elevate head of the bed 1C Place all IV lines in lower extremities 2C Consider use of loop diuretics 2C Remove indwelling catheter…
Treatment modality Potential side effects Chemotherapy Bacterial overgrowth Bile acid malabsorption Pancreatic insufficiency Neutropenic enterocolitis Edema, ulceration, atrophy Increased bowel permeability Transmural infection Radiation therapy Radiation enteritis Stricture Inflammation/cell death…
Organ RT side effect Treatment Level of evidenceb Hematologic Neutropenia Consider G-CSF (see Chap. 15 for more detail) 1C Thrombocytopenia Platelet transfusion 1C Anemia Red blood cell transfusion; erythropoietin (EPO)-stimulating…
High risk (>90 % frequency of emesis in the absence of prophylaxis) Altretamine bCytarabine 3 g/m2/dose Procarbazine (oral) bCarboplatin Dacarbazine Streptozocin Carmustine >250 mg/m2 bDactinomycin bThiotepa ≥300 mg/m2 bCisplatin Mechlorethamine bCyclophosphamide…
Clinical scenario Recommendations Level of evidenceb Primary thromboprophylaxis Not recommended (including LMWH, warfarin, FFP) 1B Routine screening with coagulation studies or for thrombophilia not recommended 2C Thrombophilia screening can be…
Disease Potential side effect Treatment Level of evidenceb Acute lymphoblastic leukemia Leukostasis Rapid initiation of chemotherapy 1A Hyperhydration 1C Consider leukapheresis for WBC >400–600 × 109/L if no delay in antileukemic chemotherapy…
