Patient's Query
Hello doctor,
I want to have an opinion about my daughter's (eight years old) chemotherapy treatment for B-cell acute lymphoblastic leukemia. I want to know if it is possible to start or continue chemotherapy at very low counts of WBC and WBC differential.
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
Your child has B-cell acute lymphoblastic leukemia. In that case, to induce remission, induction chemotherapy should be given to restore normal bone marrow. After induction, maintenance chemotherapy is also to be given. Your total count might be low because of chemotherapy, but your daughter was having 87% blasts, so chemotherapy should be given.
You can investigate further with a molecular study of different translocations, which reflects prognosis in the case of ALL (acute lymphoblastic leukemia). So consult your hemato-oncologist for examination, and under the guidance of the oncologist, chemotherapy should be given.
I hope it helps.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
The doctors adopted ALL BFM-95 protocols and administered a total of 9 chemos within that span of time. My query is whether it is possible to administer Methotrexate, Vincristine, Daunorubicin and L-asparaginase continuously in spite of low counts of WBC, especially neutrophils.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
You are going through a very tough situation with your daughter. Your daughter is having a very low WBC count, and it is called severe neutropenia. But the decision has to be individualized after clinical correlation. Induction chemotherapy can be completed under strict doctor observation. In neutropenia, the chance of infection is present. So if any unusual bleeding, prolonged vomiting, fever, etc., occur, then infection should be ruled out.
Meanwhile, care can be taken in the form of providing nutritious foods like green leafy vegetables and fruits, and handwashing should be encouraged. So, if possible and no infection is present, then chemotherapy can be continued, in my opinion. WBC transfusion can be given to raise the neutrophil count, but that has to be discussed with your treating doctor and as needed after clinical correlation.
I hope it helps.
Take care.
Patient's Query
Hi doctor,
Thank you so much for the response.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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