Lifestyle recommendations and outpatient management of children and teenagers with cancer in Europe
Dear colleague,

We are writing to you from the Support Working Group from the Spanish Haematology and Oncology Society.

We would kindly ask you to answer these questions regarding outpatient management and what are/not allowed to do/go children with cancer during treatment.

These are general questions which refer to stable, without active infection or acute complications patients.

We would very much appreciate, if possible, a representative answer or different answers from all the areas: Malignant Haematology, CNS tumours, non-CNS solid tumours and Bone Marrow Transplant.

Thank you very much for your help.
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Where are you working (hospital name, country)? *
What is your current position? *
Are you responsible of the care of... *
Required
1. Do you have printed or online information or specific meetings for new patients with lifestyle recommendations? *
Required
2. Are patients offered outpatient management in the follow treatment phases (in case of no active acute complications or infections or infections requiring hospital management)?
3. During aplasia after treatment, and in between chemotherapy cycles, how often are outpatients scheduled for laboratory and clinical review?
Once a week
2-3 times per week
Patients in aplasia are often admitted at the hospital
Patients in aplasia contact us when they have symptoms (asthenia, bleeding, fever,...) and consequently arranged for blood count
AML
ALL (not in maintenance) and NHL
HL and solid tumours such as CNS tumours, bone or STS,...
NBL during induction
Solid tumours after ASCT
4. Do you usually (not due COVID pandemic) recommend your patients to wear FPP2 mask? If you recommend to your patients the use of FPP2 mask: in which cases and situations you do so:
Generally no
Outside spaces
Inside spaces
School
Public transport
Hospital
All patients under treatment
If < 500 ANC
If < 200 ANC
AML
ALL/NHL induction/reinduction
HR-NBL induction
ASCT < 3 m
Alo-SCT < 3 m
Alo-SCT 3-6 m
Alo-SCT > 6 m with immunosuppression
5. Please choose if you advice your patients (excluding BMT) to AVOID any of the following... Please, mark the recommended NOT TO and the cases you would generally advice so:
Expected ANC> 500-800/mm3
Expected ANC 200-500/mm3 or < 200/mm3 < 5-7 days
Expected ANC < 200/mm3 during > 5-7 days
Outdoor public places
Outdoor playground
Outdoor beach, pool or sandbox
Friends visits at home (small groups)
Large family/friends gatherings
Indoor public places such as restaurants/shops
Indoor crowed public places such as public transport, cinemas, mall,...
Secondary school (> 12 years old)
Primary school (5/6-12 years old)
Kindergarten (2-4/5 years old)
Child care (< 2 years old)
Sharing room with siblings (while no signs of infection)
Pets: dogs
Pets: cats
Pets: hamsters and/or rabbits
Pets: birds
Pets: turtles
Pets: new pets
Food: raw seafood or meat
Food: unpasteurized milk or cheese
Food: uncook or unpeeled vegetables, salad, nuts,...
Food: take-out food
Food: tap water
Active sports
Aspergillosis prevention: home mold, houseplants,... or use of HEPA filter vacuums.
6. Does any of the previous recommendations change for the following diagnosis/treatment phase? Please, mark if you advice your patients to AVOID any of the following and in which cases:
Auto-SCT < 2-3 m
AML during treatment
ALL/NHL induction
ALL/NHL reinduction/HR blocks
High-risk NBL induction
Outdoor activities or playgrounds
Outdoor beach, pool or sandbox
Indoor public spaces as restaurants or shops
Indoor crowed public places: public transport, cinemas, mall,...
Social contact: friends visits at home, family gatherings,....
Primary or secondary school (> 6 years old)
Pets: dogs, cats, hamsters, rabbits,...
Pets: birds or turtles
Pets: new pets
Food: uncook or unpeeled vegetables, salad, nuts,...
Food: take-out food
Food: tap water
Active sports
Aspergillosis prevention: home mold, houseplants,... or use of HEPA filter vacuums
7. ONLY for BONE MARROW TRANSPLANT patients. Please mark if you advice your patients to AVOID any of the following and in which cases:
Auto-SCT < 3 m
Alo-SCT < 3 m
Alo-SCT 3-6 m
Alo-SCT > 6 m with some immunossuppresive treatment
Outdoor public places
Outdoor playground
Outdoor beach, private pool or sandbox
Friends visits at home (small groups)
Large family/friends gatherings
Indoor public places such as restaurants/shops
Indoor crowed public places such as public transport, cinemas, mall,...
Secondary school (> 12 years old)
Primary school (5/6-12 years old)
Kindergarten (2-4/5 years old)
Child care (< 2 years old)
Sharing room with siblings (while no signs of infection)
Pets: dogs
Pets: cats
Pets: hamsters and/or rabbits
Pets: birds
Pets: turtles
Pets: new pets
Food: raw seafood or meat
Food: unpasteurized milk or cheese
Food: uncook or unpeeled vegetables, salad, nuts,...
Food: take-out food
Food: tap water
Active sports
Aspergillosis prevention: home mold, houseplants, use of HEPA filter vacuums,...
Would you add anything else? Thank you very much for your collaboration.
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