Each child develops a unique pattern of blood counts during treatment, and observant parents can help track these changes. This appendix contains a record-keeping sheet that you can use to record your childs blood values (see Figure B-2). If there is a change in the pattern, show it to your childs doctor and ask for an explanation. Doctors consider all of the laboratory results to decide how to proceed, but they should be willing to explain their plan of action to you, so that you better understand what is happening and can worry less.
If your child is participating in a clinical trial and you have obtained the entire clinical trial protocol (discussed in Chapter 4, Clinical Trials), it will contain a section that clearly outlines the actions that should be taken by the oncologist if certain changes in blood counts occur. For example, my daughters protocol has an extensive section which lists each drug and tells when the dosage should be modified. For vincristine it states:
Vincristine: 1.5 mg/m2 (2 mg maximum) IV push weekly X 4 doses Days 0, 7, 14, 21.
Seizures: Hold one dose, then reinstitute.
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