Supportive care (also known as palliative care), is given to improve the quality of life of patients who have a serious or life-threatening disease.
Supportive care provided by attentive nursing will help prevent, or treat, the symptoms of ALL as soon as possible. It can also avoid side effects caused by treatment, and provide psychological, social, and spiritual problems related to ALL or its treatment.
It is important to advise and support patients to enable them to achieve the best response.
Patients need to be aware of their increased susceptibility for infections, enabling them to recognise any suspected symptoms of infections and report them for prompt treatment. Common symptoms of infection include:
- Fever – a raised temperature (38°C or higher)
- Aching muscles
- Diarrhoea
- Headaches
- Excessive tiredness
- Patients can help reduce their risk of infection by taking simple precautions such as:
- Washing their hands frequently, especially after using the toilet, or touching doorknobs and banisters which can be contaminated with lots of germs
- Limiting time in crowds, especially if there is an epidemic of flu or other illness
- Following food safety advice, such as cleanliness in the kitchen and not keeping food after use-by dates
- Specific advice on how patients can protect themselves from Covid‑19 infection is available on our website (https://www.leukaemiacare.org.uk/?s=Covid )
- Patients should be advised to eat a well-balanced diet to enable them to feel stronger, have more energy, and recover more quickly. If patients are having treatment, they may lose weight due to changes in taste or appetite. This may be due to the side effects of their treatment, which include sore mouth or nausea and sickness.
- Patients whose treatment includes alkaloid chemotherapies may suffer from constipation which is difficult to treat. Apart from lifestyle management and use of the currently available bulk-forming, stimulant or osmotic laxatives, new drugs to alleviate this constipation are being developed.
- Patients need to be made aware of the side effects of steroid treatment:
- Mood and behaviour changes
- Raised blood sugar levels with symptoms of feeling thirsty, needing to pass urine more often and feeling tired. Blood sugar levels need checking every day.
- Increased appetite
- Stomach pain or indigestion
- Problems sleeping
- Build-up of fluid often seen as swelling of the ankles and legs
- Supportive care also includes blood transfusions (red cells or platelets) and antibiotic, antifungal or antiviral treatment. Most commonly used are:
- Trimethoprim/sulfamethoxazole (cotrimoxazole) for pneumocystis pneumonia (PCP) prophylaxis
- Acyclovir to prevent viral infections.
- Transfusion of white blood cells is not possible because of the high likelihood of side effects, but injections of growth factors will help patients produce more white cells.
