Ordering for ALL

Question 1

When is blood flow cytometry useful in diagnosing ALL?

Answer 1

-peripheral blasts
-and high pre-test probability of ALL amenable to immunophenotypic detection of neoplastic cells, such as patients with neutropenia, absolute lymphocytosis, Lymphadenopathy or splenomegaly

Question 2

When are the IR spot for ped pt line insertions?

Answer 2

Monday and Wednesday

Question 3

What induction procedures do we typically try to schedule together under GA sedation?

Answer 3

-Marrow
-IT chemo
-Line insertion

Question 4

What trials currently open for Leukemia?

Answer 4

AML
B cell ALL
BUT not T cell ALL

Question 5

What is the diagnostic of choice if pt has circulating blast on peripheral

Answer 5

-BMA
do not need BMbx but print labels in case unable to get BMA d/t packed marrow

Question 6

For heme dx such as aplastic anemia, what is required for dx?

Answer 6

-BMA and BMbx in order to get cellularity

Question 7

Which bone marrow samples always taken care of by CRAs?

Answer 7

-“referred out” samples for both study and non-study (SOC) samples

Question 8

How many hours do we have to start chemo after giving IT chemo on a study patient AML or B cell ALL?

Answer 8

-72 hours

Question 9

What tests are always collected and sometimes collected on CSF samples?

Answer 9

-always glucose, protein and diff
-sometimes cytology, such as for Brain tumor patients

Question 10

Before ORDERING chemo, what RN double check required and signed off in EPIC _________ and_________?

Answer 10

-Weight and height

Question 11

what is the chemotherapy dose rounding rule?

Answer 11

-within 10% dry weight

Question 12

what is TPMT and NUDT genotyping?

Answer 12

-sensitivity to thiopurine drugs such as 6MP, GTG
-causes myelosuppression

Question 13

What chemotherapy level requires a form that lives above Steph’s desk?

Answer 13

asparaginase levels