Supportive Care in Hematology

Patients with hematological malignancies such as leukemias and lymphomas are predisposed to a wide spectrum of infections that need special attention. These patients are immunosuppressed not only as a result of the immune defects associated with the underlying disease, but also because of the treatment regimens that generally further decrease the patient’s resistance to infections. An intensive transfusion support with platelets, red cell concentrates, immunoglobulins, cytokines, and other drugs is necessary. Many patients also need antiemetic agents, nutritional support, pain medication, and, very often, venous catheters. All of these measures are considered supportive care and apply in a similar fashion to the high-dose treatment of solid tumors. Supportive care measures, along with the treatment and prophylaxis of infections, are discussed in this chapter. Transfusion support is discussed in Chapter 22.