Paediatric Oncology MDT Minutes

Paediatric Oncology MDT Minutes 1 November 2024 Haematology Patients **Alice Smith, DOB: 15/03/2018, MRN: PASM150318** - Diagnosis details, including subtype or relapse status: Acute Lymphoblastic Leukaemia (ALL), B-cell subtype, in first remission. - Current treatment phase, treatment status, and location of care: Maintenance phase, receiving oral chemotherapy. Care provided at the Paediatric Oncology Outpatient Clinic. - Recent clinical events, appointments, procedures, admissions, or home visits: Routine outpatient visit on 28/10/2024, no acute concerns. Received monthly vincristine and intrathecal methotrexate. - Treatment changes, delays, holds, or adjustments, including reasons: No changes or delays. Adherence to oral medication has been excellent. - Laboratory or imaging updates relevant to treatment decisions: Full Blood Count (FBC) on 28/10/2024 showed neutrophils 1.2 x 10^9/L, platelets 180 x 10^9/L. Liver function tests within normal limits. - Plans for future treatment, transfer of care, outpatient follow-up, or end-of-treatment discussions: Continue maintenance therapy as per protocol. Next outpatient follow-up in 4 weeks. Discussion regarding planned end of treatment in 18 months. - Psychological or psychosocial considerations, including patient or parental emotional state, coping strategies, and involvement of psychology or play therapy: Parents expressing ongoing anxiety about relapse but coping well. Alice is engaging well with school and play therapy sessions. - Family or social circumstances impacting care, including siblings, routines, travel, schooling, or stressors: Family recently moved closer to the hospital, reducing travel burden. Older brother (8 years old) is adjusting well to Alice's treatment routine. - Agreed MDT actions, decisions, or follow-up plans: Continue current maintenance protocol. Psychology review requested to provide additional support for parental anxiety. Ensure school liaison continues. **Tom Jones, DOB: 01/07/2020, MRN: TOMJ010720** - Diagnosis details, including subtype or relapse status: Myelodysplastic Syndrome (MDS), high-risk, recently relapsed after stem cell transplant. - Current treatment phase, treatment status, and location of care: Currently receiving palliative chemotherapy in the inpatient ward, awaiting further treatment options. - Recent clinical events, appointments, procedures, admissions, or home visits: Admitted 25/10/2024 with fever and neutropenia. Successfully treated for Gram-negative sepsis. Resumed chemotherapy today. - Treatment changes, delays, holds, or adjustments, including reasons: Chemotherapy paused for 3 days due to sepsis. Resumed at full dose as per protocol due to clinical improvement. - Laboratory or imaging updates relevant to treatment decisions: Bone marrow biopsy on 20/10/2024 confirmed relapse. FBC prior to chemotherapy showed severe pancytopenia. - Plans for future treatment, transfer of care, outpatient follow-up, or end-of-treatment discussions: Discussion regarding potential second allogeneic stem cell transplant or entry into a clinical trial if eligible. Family meeting scheduled for next week. - Psychological or psychosocial considerations, including patient or parental emotional state, coping strategies, and involvement of psychology or play therapy: Parents are distressed and exploring all possible options. Tom is experiencing significant fatigue. Play therapy involved daily. - Family or social circumstances impacting care, including siblings, routines, travel, schooling, or stressors: Parents struggling to manage care for Tom and his younger sister (2 years old). Social worker involved to assist with practical support and financial aid. - Agreed MDT actions, decisions, or follow-up plans: Multidisciplinary meeting with transplant team next week. Genetic counselling referral. Social worker to follow up on family support. Solid Tumour Patients **Sarah Davies, DOB: 09/11/2019, MRN: SADV091119** - Diagnosis details and confirmation status: Neuroblastoma, Stage 4, confirmed by biopsy and imaging. - Current disease status and treatment phase: Post-induction chemotherapy, pre-surgery phase. Partial response to chemotherapy. - Recent treatments, including chemotherapy, surgery, radiotherapy, or inpatient care: Completed 6 cycles of high-dose induction chemotherapy. No recent inpatient admissions. - Planned procedures, including timing, specialties involved, and risks discussed: Planned tumour resection surgery in 2 weeks. Surgical oncology and anaesthetics teams involved. Risks of bleeding, infection, and potential nerve damage discussed with parents. - Treatment delays, interruptions, or modifications and their clinical impact: No delays. Treatment has been tolerated well with manageable side effects. - Surveillance, imaging, or follow-up arrangements and locations: MRI and MIBG scans scheduled for 1 week post-surgery. Ongoing outpatient follow-up at the Oncology Clinic. - Patient or parental emotional responses, preferences, concerns, or expectations: Parents are anxious about the upcoming surgery but hopeful about the outcome. Sarah is generally cheerful but sometimes expresses fear about hospital visits. - Family, social, logistical, or financial considerations affecting care delivery: Parents are both working and arranging childcare for Sarah's younger brother during her hospital stay. Hospital accommodation secured for parents. - Agreed MDT decisions, actions, or next steps: Proceed with planned surgery. Pre-operative assessment by anaesthetics and surgical oncology. Ensure clear communication with family regarding post-operative care. Any Other Business Christmas Party - Number of attendees: 75 (including patients, siblings, and parents) - Feedback on family experience, satisfaction, or enjoyment: Overwhelmingly positive feedback. Families appreciated the opportunity for normalisation and social interaction. - Entertainment or activity arrangements and reception by attendees: Magician and face painter were a great success. Santa's grotto was particularly well-received by younger children.