THE NURSING OF THE PATIENTS WITH ALL USING HIGH-DOSE MTX THERAPY

Liu J, Deng ZY

Chongqing Children's Hospital, Chongqing, China

 

Objective: Observe the effect and toxicity of high-dose MTX (HDMTX) on the patients with acute lymphoblastic leukemia (ALL) and take the corresponding nursing measures to assure the chemotherapy be carried out as planned.

Methods: For the 8 patients with All in complete remission, MTX in 3g/m2, q14d x 3 times and the corresponding treatments were given to prevent the ALL occurred outside the bone marrow. During this period the major nursing measures taken included psychological care, rest and nutrition, strict sterilization of the patient room and the intensive care for the skin, mucosa, gastrointestin and the vein for venoclysis.

Results:   For the 8 patients, the bone marrow depression happened 18 times and the infections were found in 3 patients including the two with upper respiratory infections and the one with septicemia. The infections were controlled soon after using antibiotics. There were four patients having the level of ALT and AST increased. The nausea and vomiting happened in two patients, mouth ulcer was seen in one patients and the enzymes for cardiomyo was abnormal in one patients.

Conclusions: The strict sterilization and intensive care for the skin, mucosa, gastroinstestin and the vein plus adequate fluid and alkalinize will be able to reduce the toxicity of HDMTX and assure the chemotherapy be carried out as planned.

 

 
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