dryness, erythema, pruritus, skin breakdown, desquamination; skin care daily - dont wash off markings -no clothes, tape, etc. used on skin, no sun exposure, get OK of radiation oncologist before using creams, lotions deoderants; if breakdown- culture, antibiotics donor white cells attack child's tissues - skin, GI, liver other organs; skin rash beginning on hands, feet redness may blister; diarrhea, jaundice, infection, death; symptomatic support, immuno-suppressive drugs (steroids), isolation, TPN, monitor s/s of infection, s/s of other organ involve result from bone marrow suppression or infiltration of brain and respiratory tissue with high numbers of leukemic blast cells. Suppression results in anemia and thrombocytopenia (150,000-400,000 normal, 100,000 bad, 20,000 spontaneous) with hemorrhage GI and central nervous system (stroke) most common.
-treatment - packed cells, platelet transfusion, vitamin K, fresh frozen plasma for thrombocytopenia and hemorrhage. Hyperleukocytosis - hydration, bicarbonate infusion, allopurinol