Reply To: induction questions

  • Emily Fulford

    Member
    March 29, 2023 at 12:57 pm

    Hello Andria,

    Our standard practice historically has been to discharge all patients newly diagnosed with leukemia, regardless of immunophenotype or risk stratification, on Day 8. I am leading a QI to individualize discharge based on clinical stability, adherance with PO meds, and readiness for discharge to be as early as Day 4 following pegasp administration, again regardless of immunophenotype or risk stratification. 

    We do not give fungal prophylaxis in novel leukemia patients unless they have T21 or infant leukemia. We have standard practice for populations that receive fungal prophylaxis based on best evidence.

    Hope this helps.

    Emily

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    Emily Fulford, MSN,PNP,CPNP-PC
    Toronto, ON
    Canada
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    Original Message:
    Sent: 03-28-2023 11:22 AM
    From: Andria Kokoszka
    Subject: induction questions

    Hello,

    I have a few questions about your practices for ALL patients during induction…

    Do you discharge your patients who are clinically stable on day 4 after PEG dose, or do you keep them longer? Do you have the same practice for all patients regardless of risk status or if they have T or B ALL? Or would your decision differ based on their diagnosis?

    Do you standardly give fungal prophylaxis during induction for ALL patients? Again, do you have the same practice for all patients regardless of risk status or if they have T or B ALL?

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    Andria Kokoszka, CPNP-AC, CPON
    Pediatric Nurse Practitioner
    St. Jude Affiliate Clinic at Novant Health Hemby Children’s Hospital
    Charlotte, NC
    USA
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