C09983122 / invoice 10000

Reason: Chemo Dropoff- week 23 VCRDiagnosis: B-cell lymphoma (stage 3) History: Presented for week 23 treatment 15 chemo CHOP - VCR. Enlarged prescapular, mandibular and popliteal lymph nodes noted on 22/8/25. Cytology was consistent with lymphoma. ICC showed B cell. See previous hx for further details Previously had diarrhoea and grade III neutropaenia and grade II thrombocytopaenia post doxorubicin chemotherapy. Examination:Weight 5.8kg Body condition score 4/9 HR 120, cardiac auscultation wnl RR panting, normal bronchovesicular sounds. Mm pink, crt<2 Temp 39.3 Abdominal palpation comfortable and unremarkable. Femoral pulse synchronous with heart rate , normal strength. Peripheral lymphadenopathy wnl. Right submandibular LN bilobed wnl Left submandibular LN wnl Right prescapular wnl Left prescapular wnl Right axillary wnl Left axillary wnl Right popliteal wnl Left popliteal wnl Right inguinal wnl Left inguinal wnl Laboratory: CBC> HCT 45.8 % PLT 346 K/µL LYM 1.08 x10^9/L - wnl NEU 5.24 x10^9/L - wnl Assessment: Suitable for chemotherapy today. Treatment: Weight = 5.8 kg = 0.326 m2 Vincristine (1mg/mL) 0.7mg/m2 = 0.22 mg = 0.22 ml LHL used Cerenia 1mg/kg IV diluted Treatment: 1) Maropitant 12mg (Cerenia 24mg, 1/2 tab) PO sid Plan: Next chemo in 2 weeks (Doxo), week 25 - Final treatmentNotes: Notes for follow up clinician: Doxorubicin was given at 30mg/m2 at week 4 and caused grade III neutropenia and thrombocytopenia, diarrhoea. We have reduced the dose this time to use 1mg/kg (for <10kg). Previous neutropenia noted after cyclophosphamide IV 250mg/m2, for future cyclophosphamide, please use 10% dose reduction at 220mg/m2    Vital Signs    Weight: 5.8;