What to expect during the treatment phase (Days 1-5)

Day 1

When you arrive for your appointment in the Outpatient Complex Malignant Hematology (CMH) unit located on the 6th floor – C wing, room 06 (C606), you will meet with a nurse to talk about your treatment and any concerns you have.

Be prepared to wait. Before your consolidation chemotherapy can safely begin, your health care team may have to wait for test results. Some of these tests may be blood tests, bone marrow biopsy or heart tests.

Your Day 1 appointment will last about 5-6 hours. You will get all the treatments listed below.

Intravenous (IV) fluids

Intravenous (IV) fluids will help to keep your body hydrated while you get chemotherapy. Hydrated means that your body has enough water and salt.

You will get these by IV (directly into your blood) through your central venous catheter.

Daunorubicin Chemotherapy

Daunorubicin is given by IV through your central venous catheter. It takes 5-10 minutes to give.

Cytarabine Chemotherapy

Cytarabine is given by IV through an ambulatory infusion pump (AIP) in central venous catheter. The first dose takes 3 hours to give. Some of this dose will be given in clinic through your pump, and then you will get sent home for the rest of the dose through your pump.

You will get another dose of Cytarabine by IV through your central venous catheter at home.

The AIP will connect to your central venous catheter. You will take the AIP home with you overnight. The nurse will set a timer on the pump so you get your medicine at a specific time. You will get this dose about 12 hours after the start of your first dose of Cytarabine.

You will get an AIP booklet explaining how to use the AIP at home.

AIP Machine

Day 2

When you arrive for your appointment, you will meet with a nurse to talk about any side-effects you may have from the chemotherapy.

Your Day 2 appointment will last about 2-3 hours.

You will get all the treatments listed below.

Intravenous (IV) fluids

Intravenous (IV) fluids will help to keep your body hydrated while you get chemotherapy. You will get these by IV through your central venous catheter.

Daunorubicin Chemotherapy

Daunorubicin is given by IV through your central venous catheter. It takes 5-10 minutes to give.

Day 3

When you arrive for your appointment, you will meet with a nurse to talk about any side-effects you may have from the chemotherapy.

Your appointment will last about 4-5 hours.

You will get all the treatments listed below.

Intravenous (IV) fluids

Intravenous (IV) fluids will help to keep your body hydrated while you get chemotherapy. You will get these by IV through your central venous catheter.

Cytarabine Chemotherapy

Cytarabine is given by IV through an ambulatory infusion pump (AIP) in your central venous catheter. The first dose takes 3 hours to give. Some of this dose will be given in clinic through your pump, and then you will get sent home for the rest of the dose through your pump.

You will get another dose of Cytarabine by IV through your central venous catheter at home.

Day 4

When you arrive for your appointment, you will meet with a nurse to talk about any side-effects you may have from the chemotherapy.

The nurse will take blood from your central venous catheter. This blood will be used to check your hemoglobin (red blood cells), platelets (blood clotting cells) and neutrophils (white blood cells that fight infections).

Your Day 4 appointment will last about 2-3 hours.

You will get all the treatments listed below.

Intravenous (IV) fluids

Intravenous (IV) fluids will help to keep your body hydrated while you get chemotherapy. You will get these by IV through your central venous catheter.

Transfusion

You may or may not need a transfusion today depending on the results of your bloodwork and how you are feeling. Your appointment may last longer than 2-3 hours if you need a transfusion.

Day 5

When you arrive for your appointment, you will meet with a nurse to talk about any side-effects you may have from the chemotherapy.

Your Day 5 appointment will last about 4-5 hours.

You will get all the treatments listed below.

Intravenous (IV) fluids

Intravenous (IV) fluids will help to keep your body hydrated while you get chemotherapy. You will get these by IV through your central venous catheter.

Cytarabine Chemotherapy

Cytarabine is given by IV through an ambulatory infusion pump (AIP) in your central venous catheter. The dose takes 3 hours to give. Some of this dose will be given in clinic through your pump, and then you will get sent home for the rest of the dose through your pump.

You will get another dose of Cytarabine by IV through your central venous catheter at home.

Day 6

Your ambulatory infusion pump (AIP) will need to be disconnected from your central venous catheter. Also, your central venous catheter will need to be flushed after your chemotherapy is done. Your team in C606 will refer you to the Home and Community Care - LHIN

(FORMERLY Community Care Access Centre - CCAC) and they will contact you at home A nurse may come to your home OR you may be asked to attend a community clinic near your home to have your AIP disconnected and have your catheter cleaned.

What to do if you develop a fever during your Treatment phase (Days 1-5) ONLY

Please note: These instructions are only for the Treatment phase (Day 1-5) ONLY

If you develop a fever of 38.0°C (100.4°F) or higher, take 1000 milligrams (mg) of Acetaminophen (Tylenol®). You can only take Acetaminophen (Tylenol®) one time. A fever during the treatment phase can be a side effect from the Cytarabine Chemotherapy rather than an infection.

You must go to an Emergency Room right away if:

Your temperature does not go down after taking Acetaminophen (Tylenol®) one time.
If your fever comes back again after taking Acetaminophen (Tylenol®) one time.
Your body starts to shake a lot.
You become sleepy at a time when you should not be sleepy.
You are confused in your thinking.