3.4 Treatment planning

3.4 Treatment planning

New diagnostic techniques in the biology of CAYA acute leukaemia continue to develop rapidly. The multidisciplinary team needs to be aware of these changes and advances and ensure they are translated to clinical management. CAYA acute leukaemia patients being enrolled in clinical trials

is important and associated with superior outcome. The team must know which suitable clinical trials are available for CAYA acute leukaemia. If there is no open clinical trial then every specialist CAYA acute leukaemia service should have a predefined, peer-reviewed treatment model that the multidisciplinary team has endorsed.

A number of factors should be considered at this stage:

  • the patient’s overall condition, life expectancy, personal preferences and decision-making capacity
  • discussing the multidisciplinary team approach to care with the patient
  • appropriate and timely referral to an MDM
  • pregnancy and fertility
  • support with travel and accommodation
  • teleconferencing or videoconferencing as required
  • educational

More information

For more information see the Victorian paediatric oncology care pathways: Providing optimal care for children and adolescents – acute leukaemia, central nervous system tumours and solid tumours (May 2019)

Induction treatment is often required before a full MDM ratifies details for the ongoing management plan. All CAYA will be inpatients when treatment starts, allowing their initial multidisciplinary management to be performed on the ward.

All CAYA acute leukaemia should be discussed as soon as possible after diagnosis at an appropriate MDM, with further discussions at the time of response assessment or final risk stratification.

All CAYA acute leukaemia should also be discussed at suitable MDMs that will include psychosocial and supportive care assessment.

Results of all relevant tests and access to images should be available for the MDM. Information about the patient’s concerns, preferences and social and cultural circumstances should also be available.