Talking With Your Doctor

A good relationship between parents and the healthcare team is one based on frequent and open communication, honesty, and excellent care. Remember that your doctor or nurse cannot read your mind—or your child’s mind. Don’t be afraid to speak up if you don’t understand something—you cannot explain something to your child if you don’t understand it yourself.

Get to know the team

As you may already have realized, children who are diagnosed with leukemia are usually assigned a healthcare team that includes an oncologist (doctor who specializes in cancer) and an oncology nurse. But they may also see a number of other healthcare professionals—doctors, nurses, x-ray technicians, nutritionists, and more. Your nurse can be a good resource to find out who your primary team is, and who can be most helpful for any issues that may arise.

Ask questions

If your child is just starting cancer therapy, you probably have many questions. Don’t be afraid to ask your doctor or nurse. If they explain things too quickly, ask them to slow down and repeat the information. If you don’t understand words they’re using, ask them to explain it a different way. Some parents find it helpful to go to all appointments with a written list of questions. This can help you be sure not to forget anything.

Remember that your healthcare team is your greatest resource when it comes to information about your child’s leukemia. Keeping communication open and honest with the doctor and nurse is vital in cancer care.

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How Clolar is Used

Clolar is a type of medication to treat children, ages 1 to 21 with a type of leukemia called relapsed or refractory acute lymphoblastic leukemia (ALL), after at least 2 other treatment attempts have failed. Clolar can reduce the number of leukemia cells in the blood. At this time we do not know if Clolar will help a child with ALL live longer or cure him or her of the cancer.

Important Safety Information for Patients

Serious side effects

Clolar can cause serious side effects that include:

• Systemic inflammatory response syndrome (SIRS)/capillary leak syndrome (CLS). Signs include fast breathing, fast heartbeat, low blood pressure, and difficulty breathing. These signs should be reported to the physician right away, as SIRS and CLS can be life-threatening if not treated right way. If your child experiences clinically significant signs of SIRS or CLS, your physician should stop Clolar immediately and consider giving your child steroids, diuretics, and albumin. When your child has stabilized, Clolar can be continued, usually at a lower dose.
• Bone marrow suppression and infection. Clolar can stop your child’s bone marrow from making enough red blood cells, white blood cells, and platelets. Serious side effects can result from this, and include severe infection (sepsis), bleeding, and anemia.
• Effects on pregnancy and breastfeeding. Females should not become pregnant or breastfeed during treatment with Clolar because Clolar may harm the baby.

Other side effects

The most common side effects with Clolar are stomach problems (including vomiting, diarrhea, and nausea), and effects on blood cells (including low red and white blood cells count, low platelet count, fever, and infection). A fast heartbeat has been noted in some patients taking Clolar. Clolar can also affect the liver and kidneys. For these reasons, your child’s healthcare professional will do blood tests to monitor his or her blood cells, kidney function, and liver function.

Treatment with Clolar quickly reduces the number of leukemia cells in your child’s blood. For this reason, your doctor should monitor your child for signs and symptoms of tumor lysis syndrome (TLS), as well as signs and symptoms of cytokine release, which can develop into SIRS, CLS, and organ problems. Your doctor is encouraged to give continuous IV fluids throughout the five days of Clolar treatment to reduce certain side effects. Your doctor may also prescribe allopurinol to reduce the build-up of uric acid that occurs with TLS. Your doctor should stop the Clolar treatment if your child develops low blood pressure for any reason during the five days of treatment.

Please speak with your healthcare professional if you have questions about Clolar. Also, please see full prescribing information.