How To Make An Appointment | Call the
Department of
Pediatrics at
212-639-5954 | |
|
|
Treatment Decisions
Most patients, adults and children, will be treated according to cooperative group protocols. Often these will be clinical trials seeking to improve outcomes. Some drugs are more effective against specific subtypes of leukemia, and treatments are often based on the patient's specific gene mutation. Your doctor will discuss this during the treatment consultation following immunophenotyping and other diagnostic tests.
During Treatment
Side effects during remission induction can be significant, and patients usually remain in the hospital for a period of four to six weeks. Treatment for AML is aimed at the leukemic blood cells, but normal blood cells are also affected by chemotherapy treatment. All patients undergoing treatment will experience lowered blood counts that lead to a variety of symptoms.
Low white blood cell counts put patients at increased risk of infection. Treatment with antibiotics to prevent or treat infection is likely. In some situations, the patient will be in isolation, and visitors to the patient's room may need to wear gowns, masks, and gloves to reduce the risk of infection.
Low white blood cell counts generally also lead to inflammation of the mucous membranes in the mouth and gastrointestinal tract. This is called mucositis. The tissues become very dry and may crack or bleed. Specific oral care regimens help minimize discomfort and prevent secondary infections. Mouth sores can make eating painful. The mouth sores themselves can cause pain that requires pain medication.
Nausea, vomiting, and diarrhea are side effects for which effective treatments exist. Hair may fall out, and this is can be an especially upsetting side effect. Wigs and scarves may help minimize the distress hair loss causes.
Low platelet counts lead to easy bruising and bleeding. Taking care to prevent injuries is very important. Low red blood cell counts causing anemia make patients feel tired and weak. Sometimes, patients may be short of breath or experience a fast heartbeat rate. Transfusions will be necessary to replace red blood cells and platelets. Many patients are given stimulating factors called G-CSF or GM-CSF. These stimulate the development of new white blood cells so that cell counts are low for a shorter period of time.
The initial course of treatment and the severity of side effects can be very difficult and wearing on patients. While blood counts are low, your child may find it difficult to carry on normal activities. *Simple exercise, such as walking, may seem overwhelming. Your doctors and nurses will do everything in their power to minimize the discomfort, sadness, and boredom that are common during this initial phase of treatment. Social workers, psychiatrists, and psychologists can help you and your child with depression and the ups and downs you will experience during treatment. Social workers can also help with financial issues related to treatment. Finally, all hospitals have clergy who are available to speak to you and provide spiritual support and guidance.
Resuming Activities
After the initial hospitalization, patients will slowly begin to resume their normal activities, but school may have to be postponed for many months. Subsequent shorter hospital stays, ranging from one to two weeks, may be necessary to administer chemotherapy and treat infections that result from low white blood cell counts. Strength and stamina will return gradually. The doctors and nurses will provide more specific guidelines on what is to expect based on individual treatment regimes and individual responses to treatment.
