Example of annual follow up after therapy for AML:
| Investigation |
Important aspects to screen for: |
| History |
General:
- Level of energy, general health
- Depression
- Social/employment situation
- Exercise
- Smoking, recreational drugs and alcohol ingestion
Chemotherapy related:
- Symptoms of cardiac dysfunction related to anthracycline induced cardiomyopathy (e.g. shortness of breath on exertion, palpitations and orthopnoea)
- Back pain, history of fractures - after intensive chemotherapy patients are more at risk for osteoporosis
|
| Examination |
General:
- Blood pressure
- Weight and height (BMI)
- General examination
|
| Blood work |
General:
- Routine blood work including blood count, electrolytes, BUN, serum LDH and creatinine and liver function tests
- Screen for hepatitis if treated in North America before 1992 and received a blood transfusion
|
| Special investigations |
General:
- After anthracycline exposure - echocardiogram every 3 years or so
|
Specialist
follow-up |
General:
- Anyone who has had intensive chemotherapy is likely to be at risk for early onset osteoporosis and should be seen in consultation by a specialist with expertise in this area.
|
| Supportive care |
- Family counselling
- Psychology
|
| Advice |
Lifestyle:
- Advise about diet, exercise and lifestyle choices (such as smoking) which may increase the risk of vascular disease.
- Diet rich in Vitamin D, calcium and dairy servings to reduce risk of osteoporosis.
- Regular exercise is very important. After exposure to any anthracycline there is a risk for cardiomyopathy. Cardiac fitness is very important.
|
Patient information
(COG) Survivorship Guidelines |
General:
|
