C10015573 / invoice 10000

11/03/2026 Diagnosis: Mediastinal lymphoma; high grade, hypercalcaemia at diagnosis; T cell lymphoma; pre-treated with L-spar and dex/ pred, CHOP (2 cycles)/ LOPP protocol (3 cycles); relapsed at end of 3rd LOPP cycles; changed to Doxorubicin #3/ cyclophosphamide. DELAYED 

History: Marcus reported Banjo has experienced hyporexia intermittently on the past week. Additionally, Banjo has exhibited increased thirst and experienced diarrhoea this morning. His energy levels remain normal.

Physical Examination findings: Bright, alert and responsive.
Heart&Lungs: no murmur or arrhythmia on auscultation, normal respiratory effort and bronchovesicular sounds bilaterally
Abdomen: tense, but no pain elicited 
Rectal: normal intestinal lining no internal lymphadenopathy
LN: all peripheral lymph nodes palpate normally
MSK; ambulatory x4, normal gait
Integ: one pigmented, raised and well demarcated mass on the left thorax (remains static)
Mm pink, crt < 2 secs, HR 102, RR 32, Temp 38.0, Wt:9.6

Laboratory results: CBC performed in house with manual blood film assessment.
Hct: 0.338
WCC: 6.96
Neuts: 5.89
Platelets:24

Manual differential count:  Neutrophils 90%, Lymphocytes 2%, Monocytes 8%, Eosinophils 0%.
Platelets: clumped but not adequate
Morphology: Normal 

Treatment: DELAYED Doxorubicin
Anti-nausea as required 
Pro-kolin as required for diarrhoea. 

Recommendation: Marcus was advised to trial anti-nausea for 3-4 days for aid Banjo's appetite, 

Comments: It was a pleasure to see Banjo today.We withheld Banjo's treatment due to Bajo's hyporexia and the acute onset of diarrhoea. Additionally, the persistent thrombocytopenia persists; whether it is related to Bajo's lymphoma or bone marrow suppression secondary to chemotherapy is unknown at this time. A brief FAST survey was performed, which did not reveal any evidence of chest effusion, indicating that the current treatment has been effective.

We will see Banjo again in 3 weeks' time.  Please feel free to call or email if you have any further queries regarding Banjo.