Intent of treatment for CAYA acute leukaemia is curative.

Treatment options

• Chemotherapy with or without immunotherapy is the key component for treating CAYA acute leukaemia.
• Radiation therapy has a role in some CAYA acute leukaemia patients with testicular disease or overt central nervous system disease. Radiation therapy is used as part of the conditioning regimen for patients undergoing haematopoietic stem cell transplantation. It can be useful in palliating symptomatic masses in advanced disease.
• haematopoietic stem cell transplantation is reserved for patients at greatest risk of relapse. It is used as a salvage where primary treatment has failed.

Palliative care

Early referral to palliative care can improve quality of life and in some cases survival. Referral should be based on need, not prognosis. For more information, visit the Palliative Care Australia website .

Communication

The lead clinician and team’s responsibilities include:

• discussing treatment options with the patient, family and/or carer including the intent of treatment as well as risks and benefits
• discussing advance care planning with the patient, family and/or carer where appropriate
• communicating the treatment plan to the patient’s GP
• helping patients to find appropriate support for exercise programs where appropriate to improve treatment outcomes.

Checklist

• Intent, risk and benefits of treatment discussed with the patient and/or carer
• Treatment plan discussed with the patient and/or carer and provided to GP
• Supportive care needs assessed and referrals to allied health services actioned as required
• Patient referred to support services (such as Camp Quality, Cancer Council, Canteen, Leukaemia Foundation and Redkite) as required
• Early referral to palliative care considered and advance care planning discussed with the patient and/or carer

Timeframe

As soon as possible after presentation.