Name That Cancer: The Usual Suspects
A 5 year old is brought in for several weeks of fatigue, pallor, leg pain, and intermittent fevers. CBC shows anemia and thrombocytopenia, with circulating blasts. Which malignancy should be high on your differential?
What is pediatric ALL?
This chemotherapy drug is famously red/orange in color and is commonly given as a slow IV push or short infusion
What is doxorubicin?
This commonly used chemotherapy agent is notorious for alopecia, myelosuppression, and cardiotoxicity. Which drug are we talking about?
What is Doxorubicin?
Doxorubicin
What is the heart?
This is the most common childhood cancer.
What is acute lymphoblastic leukemia (ALL)?
A child presents with fever, bruising, petechiae, and fatigue. You notice gingival swelling on exam, and the CBC shows circulating blasts. Labs also show coagulopathy with prolonged PT/PTT. Which pediatric malignancy is particularly associated with this finding?
What is AML?
Your patient is receiving this monoclonal antibody as part of lymphoma therapy. The first infusion is typically started slowly and titrated upward according to institutional protocol, with subsequent infusions potentially being faster if tolerated. What drug is this?
What is Rituxumab?
A child receiving treatment for ALL develops foot drop, decreased deep tendon reflexes, and constipation. Which chemotherapy drug is the classic culprit?
Bleomycin
What are the lungs?
This is the most common extracranial solid tumor in children.
What is neuroblastoma?
A 3-year-old is brought to clinic after a parent notices a large, firm abdominal mass while giving them a bath. The child otherwise looks relatively well. What pediatric malignancy should you suspect?
What is Wilms tumor?
A patient is receiving high-dose methotrexate. What additional medication is routinely used after high-dose methotrexate to help protect normal cells?
What is Leucovorin?
A child receiving chemotherapy for Hodgkins Lymphoma develops a new dry cough, dyspnea, and hypoxemia. Pulmonary toxicity is a classic concern with this medication.
What is Bleomycin?
Methotrexate
What is the kidney?
This pediatric tumor is unusual because, particularly in infants, it can sometimes undergo spontaneous regression without treatment.
What is neuroblastoma?
A 2-year-old presents with abdominal distention and a firm abdominal mass. The family reports decreased appetite and constipation. They also note that the child has dark circles under their eyes which they thought was from allergies - what malignancy should you suspect?
What is neuroblastoma? (Orbital/bony involvement)
Your patient with acute lymphoblastic leukemia has a diagnostic LP and is found to have disease in the CNS -she will received extra doses of THIS medication intrathecally in order to clear her CNS disease
What is Methotrexate?
A child receiving this chemotherapy develops rising creatinine and electrolyte abnormalities. The nurse is particularly concerned about renal tubular injury and magnesium wasting. Which drug is most likely responsible?
What is Cisplatin?
Peg-Aspariginase
This chromosome abnormality gets its name from the city where it was first identified and is associated with a specific leukemia subtype.
What is the Philadelphia Chromosome?
A teenager recently completed therapy for Ewings Sarcoma and received Vincristine/Doxorubicin/Cyclophosphamide/Etoposide/Ifosfamide - about 8 months from the end of therapy he presents for routine follow up and has pancytopenia with circulating blasts - what is the diagnosis?
Therapy-related AML (t-AML)
This chemotherapy drug is a vesicant that is given IV and may be pushed or infused depending on the protocol. There is one absolute rule about its route of administration: it must never be given intrathecally.
What is Vincristine?
A child received treatment for acute lymphoblastic leukemia develops abdominal pain and is found to have pancreatitis. His friend developed a stroke soon after getting the same medication. What is the culprit?
What is PEG-Aspariginase?
Vincristine
What is the peripheral nervous system?
Unlike most medications dosed simply by weight, many chemotherapy drugs are dosed using this measurement calculated from a patient's height and weight
What is body surface area?