Table 3.

Recommendations for monitoring and supportive care in children with CML receiving TKI therapy

• Accurate measurement of height and weight at each visit and close monitoring of growth velocity. Consider bone scan and DEXA scan and refer to endocrinology if there is evidence of an abnormal growth pattern.

• Tanner staging at each visit. Consider checking gonadotropins and sex steroids and refer to endocrinology if there is evidence of a pubertal delay.

• Thyroid function (TSH, free T4) 4 to 6 weeks after start of TKI and annually thereafter.

• Counseling on reproductive considerations for young women of childbearing age.

• Annual echocardiogram and electrocardiogram.

• Live vaccines are not recommended. Inactivated vaccines may be given safely, but their efficacy has not been proven.

DEXA, dual-energy x-ray absorptiometry; T4, thyroxine; TSH, thyroid-stimulating hormone.