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33 - Hematologic supportive care

from Part IV - Complications and supportive care

Published online by Cambridge University Press:  01 July 2010

By
Fariba Navid  and
Victor M. Santana
Edited by
Ching-Hon Pui
Fariba Navid
Affiliation:
Assistant Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
Victor M. Santana
Affiliation:
Member and Director, Solid Tumor Division, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
Ching-Hon Pui
Affiliation:
St. Jude Children's Research Hospital, Memphis
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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 during periods of morbidity due to therapeutic interventions. 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, most recently, the use of hematopoietic growth factors to ameliorate hematologic complications. In this chapter, we review the current status of blood component support, intravenous catheter placement, and supportive therapy with granulocyte colony-stimulating factor and other cytokines. Although the focus is on experience with childhood leukemias, some examples are drawn from experience with solid tumor patients, 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 United States has increased exponentially. Each year, approximately 12 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 or by bone marrow aplasia due to tumor cell infiltration.

The use of red cell and plasma products has remained constant over the last decade, while platelet usage has steadily increased.

Type
Chapter
Information
Childhood Leukemias , pp. 829 - 849
Publisher: Cambridge University Press
Print publication year: 2006

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  • Hematologic supportive care
    • By Fariba Navid, Assistant Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Victor M. Santana, Member and Director, Solid Tumor Division, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.034
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  • Hematologic supportive care
    • By Fariba Navid, Assistant Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Victor M. Santana, Member and Director, Solid Tumor Division, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.034
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  • Hematologic supportive care
    • By Fariba Navid, Assistant Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Victor M. Santana, Member and Director, Solid Tumor Division, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.034
Available formats
×