Caring for Your Child

As you may already know, caring for children with leukemia requires a delicate balance between tending to their emotional and physical needs, and trying not to spoil or overindulge them. This can be a challenge, so here are some tips that may be useful.

Talk Honestly

Children need to know that they can talk openly to you about their leukemia, and that you will talk openly to them. Honest communication can relieve uncertainty and anxiety, and will go a long way toward building trust.

If your child asks a question that you can’t answer, write it down and ask your doctor or nurse during your next visit. Reassure your child that you will do your best to help them understand what is happening to them, and that they can depend on you to tell them the truth. If you need help with communicating difficult information, talk to a doctor or counselor for advice.

Address Behavioral Changes

Although children with leukemia often display astounding levels of maturity and bravery in coping with their illness, most experience anger, tantrums, and withdrawal at least occasionally. While these feelings are normal and understandable, it is important not to let them get out of control.

It is natural for parents to want to overlook behavioral problems that would get siblings in trouble, but family life will be smoother if you continue to set limits and consistently stick to your set of family rules.

Controlling your own feelings of anger and frustration is an important first step. Children often model the behavior of their parents and other adults. If your child is angry or hostile, try to deal with it as you would if he or she wasn’t sick. This might include time-outs or loss of privileges. If tantrums are frequent, a professional counselor can help a child learn to channel anger appropriately.

Keep in mind that some medications can have an effect on your child’s mood. Ask your doctor or nurse if this may be the case in your child, and what they may recommend to address such issues.

Most experts say that temporary withdrawal can be a good way to come to grips with strong feelings. But ongoing withdrawal can be a sign of depression. Try to help your child learn to express feelings safely, and consider professional counseling if withdrawal persists.

Offer Praise

Your child will undoubtedly struggle with many physical and emotional challenges over the course of treatment. Be sure to express your pride and admiration for his or her strength and perseverance. Also, when appropriate, praise your child for his or her ability to communicate feelings about the disease.

Reach Out

You may wish to talk with other parents of children with cancer. Advocacy and support groups can be a great resource. Learn more about these kinds of groups.

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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.