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33 - Hematologic supportive care

from Section 4 - Complications and supportive care

Published online by Cambridge University Press:  05 April 2013

By
Fariba Navid  and
Victor M. Santana
Edited by
Ching-Hon Pui
Ching-Hon Pui
Affiliation:
St Jude's Children's Research Hospital
Get access

Summary

Introduction

The great strides that have been made in curing children of acute leukemia can be attributed in part to improvements in supportive care. Such care is a major component of the total patient management strategy and includes nutritional support, prophylaxis against life-threatening infections, empiric use of antibiotics during periods of neutropenia, blood component support, adequate venous access, and the use of hematopoietic growth factors to ameliorate hematologic complications. This chapter reviews the current status of blood component support, intravenous catheter placement, and supportive therapy with granulocyte colony-stimulating factor (G-CSF) and other cytokines. Although the focus is on experience with childhood leukemias, some examples are drawn from experience with patients with solid tumors, particularly in situations where limited data are available from leukemia studies.

Blood component support

Since 1828, when Blundell initiated the use of blood transfusion to counteract postpartum hemorrhages, the demand for blood component products in the USA has increased exponentially. Each year, approximately 14 million units of blood are transfused in this country, with surgery, motor vehicle accidents, and complications of cancer accounting for the majority of this usage. Cancer patients receive blood component support because of deficient hemoglobin levels and platelet counts caused by the suppression of blood cell progenitors through chemotherapy or tumor cell infiltration of bone marrow, or because of alterations in the plasma coagulation proteins.

Type
Chapter
Information
Childhood Leukemias , pp. 794 - 813
Publisher: Cambridge University Press
Print publication year: 2012

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