How should I manage a patient with newly diagnosed leukaemia in terms of supportive care and symptom management?

Supportive care and symptom management for a patient with newly diagnosed leukaemia should include:

• Systematic assessment of physical symptoms at key points such as diagnosis, treatment episodes, relapse, and end of life, including enquiry about symptoms rather than waiting for spontaneous reporting, and understanding their impact on daily life (e.g., sleep disturbance) ¹.
• Prompt initiation of treatment for symptoms to prevent worsening, with regular prophylactic treatment preferred over 'as required' dosing for persistent symptoms ¹.
• Management of complications related to leukaemia and its treatment, including infection prevention and treatment, bleeding risk, and neutropenia, with access to specialist haematology care and facilities equipped for rapid management of emergencies such as neutropenic sepsis ².
• Psychological assessment and support at diagnosis and throughout the illness, with referral to specialist psychological services if significant distress is identified, delivered in a private and supportive environment ¹.
• Social and spiritual needs assessment to provide holistic care, including assistance with personal care, practical aids, benefits advice, and access to spiritual support sensitive to the patient’s beliefs and values ¹.
• Multidisciplinary team involvement including haematologists, nursing, psychological support, and palliative care specialists to optimize symptom control and supportive care ².
• Regular monitoring and review of symptoms and treatment goals, with clear communication and shared decision-making with the patient ¹,².

Overall, management should be pragmatic, straightforward, and tailored to the individual’s needs, with early referral to specialists when problems exceed primary care expertise ¹,².