Management of myelosuppression in the patient with cancer

Bone marrow depression (myelosuppression) in the patient with cancer may result from the disease itself or from its treatment. The consequences of myelosuppression are numerous; the most critical problem that results from leukopenia is infection. Serious clinical consequences follow depression of normal leukocyte function. A clear understanding of the functioning of each type of leukocyte is essential for managing the various complications associated with leukopenia. The three components of myelosuppression management are: prevention of infection, frequent patient assessment for the early detection of infection, and aggressive management when such infection arises. The oncology nurse minimizes patient- and environment-related sources of infection and is aware that detection is complicated by the lack or diminution of signs and symptoms in a leukopenic patient. Infections that arise are managed in different ways, depending on the pathogen and on available therapy. In addition to conventional antimicrobial therapy, newer therapeutic modalities, such as colony-stimulating factors, may hold promise for the treatment of leukopenic patients. The nurse is responsible for many aspects of the care for these patients.