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31 Cards in this Set
- Front
- Back
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difference vs adults in monitoring etoposide
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peds have lower blood pressue and higher pulse than adults
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difference vs adults in monitoring anthracyclines
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cardiovascular toxicity may occur as long as 20 yrs after tx
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Renal Fanconi's syndrome symptoms
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glycosuria/proteinuria, renal tubular acidosis, and hypophosphatemia
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difference vs adults in monitoring cisplatin
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calculate hydration based on size. Maint fluid = 1500 mL/m2/24hr. Most protocols call for 2x maint rate to maintain urine output
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difference vs adults in monitoring ifosfamide
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Renal Fanconi's Syndrome. Should switch to cyclophos after 72 mg/m2
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difference vs adults in calculating dose
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MAY: (1) cut adult m2 dose in half (2) convert normal dose /m2 into dose/kg by assuming 1m2 child = 30 kg (3) half adult dose after conversion to mg/kg
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pediatric ALL induction chemo
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IT MTX q week x 2-4 wk
pred 40mg/m2/d or dex 6mg/m2/d x 28d vincristine 1.5 mg/m2 q week asparaginase =/- daunorubicin |
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don't give daunorubicin with
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dexamethasone, b/c higher risk of fungal infections
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radiation in ped pt?
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avoid, esp during 1st 2 yrs of life and, preferrably, 5yrs
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pediatric AML chemo regimen
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daunorubicin OR idarubicin + cytarabine
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pediatric medulloblastoma regimen
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PCV (prednisone+lomustine+vincristine) has replaced the 8-in-1 regimen. Use chemo to avoid rad or together w/rad to decrease rad dose
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positive prognosis predictors for ped neuroblastoma
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DNA index >1, no N-myc amplification, higher ratio VMA:HVA
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treatment- neuroblastoma stage I-2A
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surgical resection. If N-myc amplified, also chemo
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treatment- neuroblastoma stage 2B-3
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surgery, chemo, and possibly rad.
chemo= cyclophos+vincristine+carbo/ cis+etoposide |
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treatment- neuroblastoma stage 4
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aggressive chemo, possible transplant, possible retinoic acid as biological response modifier
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treatment- neuroblastoma stage 4S
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surgery
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blood pressure w/ Wilm's tumor
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hypertension due to renin
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radiation with osteosarcoma
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radiation plays no role in osteosarcoma since it is unresponsive
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active agents in osteosarcoma
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HDMTX, alternating with cisplatin + doxorubicin
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radiation with Ewing's sarcoma
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tumor is very radiosensitive
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Prior to initiation of chemo in ALL, what are some steps that may be necessary?
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begin allopurinol or rasburicase and start hydration. May also begin urine alkalinazation.
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When to use a 3 drug induction for pediatric ALL vs 4 drug?
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3 drug for std risk and 4 drug for high risk. High risk = age<1 yr or > 9 yrs, WBC>50k, T-cell ALL or certian translocations
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What is the 3 drug regimen for pediatric ALL?
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IT MTX + vinc + asparag + pred/dex
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What drug is added to make a 4 drug regimen for ped ALL?
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daunorubicin on d2,8,15. Must switch to prednisone (no dex due to incr fungal infections)
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Most effective regimen for pediatric AML?
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daunorubicin OR idarubicin + cytarabine
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Chemo regimen for rhabdomyosarcoma?
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VAC (vincristine+dactinomycin+cyclophosphamide)
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Goal of maintainence chemo for ALL
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maintain ANC between 500-1500. Increase or decrease doses 25% to maintain this range.
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Wilms treatment for Stage I & II favorable
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dactinomycin + vincristine, NO RAD
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Wilms treatment for Stages II - IV favorable or unfavorable
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RT included, plus dactinomycin, doxorubicin, vincristine, maybe cyclophos and etoposide
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Rhabdoid tumor treatment
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surgery + RT
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retinoblastoma treatment
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RT + chemo if metastatic. Chemo= vincristine + etoposide + carboplatin
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