MUY ALTO RIESGO
13 EVALUACION DE LA TOXICIDAD
En cada fase se evaluarán los siguientes parámetros, adaptados de la escala WHO de toxicidad. Se indicará el grado de afectación máxima.
Toxicidad: Hematológica: Hemoglobina (g/dl): 0. >=11 g/dl; 1. 9,5-10,9 g/dl; 2. 8-9,4 g/dl; 3. 6,5-7,9 g/dl; 4. <6,6 g/dl Neutrófilos (mm3): 0. >=2.000; 1. 1.500-1.900; 2. 1.000-1.400; 3. 500-900; 4. <500 Plaquetas (mm3): 0. >=100.000; 1. 75.000-99.000; 2. 50.000-74.000; 3. 25.000-49.000; 4. <25.000 Digestiva: Bilirrubina: 0. <1,25xN*; 1. 1,26-2,5xN*; 2. 2,6-5xN*; 3. 5,1-10xN*; 4. >10xN* GOT/GPT: 0. <1,25xN*; 1. 1,26-2,5xN*; 2. 2,6-5xN*; 3. 5,1-10xN*; 4. >10xN*
Mucositis: 0. no; 1. dolor, eritema; 2. eritema, ulceras (puede comer sólidos); 3. úlceras (sólo dieta líquida); 4. alimentación imposible
Diarrea: 0. no; 1. transitoria <2 días; 2. tolerable, pero >2 días; 3. intolerable, precisa tto. 4. hemorragia, deshidratación
Náuseas / Vómitos: 0. no; 1. náuseas; 2. vómitos pasajeros; 3. vómitos que requieren tto.;
4. vómitos intratables
Renal: Creatinina: 0. <1,25xN*; 1. 1,26-2,5xN*; 2. 2,6-5xN*; 3. 5,1-10xN*; 4. >10xN*
Neurológica: Neuropatía periférica: Convulsiones:
Ileo paralítico: SIADH:
Otras Toxicidades: Hiperglucemia: Alt. Coagulación: Tiflitis:
Hipoproteinemia: Exantema: Hemorragia Digestiva:
R. Anafiláctica: Cardiotoxicidad: Hemorragia Cerebral:
Otras:
Infección / Fiebre: Nº de episodios:
Episodio nº 1: 1. fiebre sin foco; 2. con foco
Localización: 1. Sepsis 2. Cutánea 3. Gastroenteritis 4. Neumonía 5. Urinaria 6. ORL 7. Catéter 8. Meningitis 9. Otros Germen: 1. Bacteria 2. Virus 3. Hongo 4. Parásito Especificar germen:
Episodio nº 2: 1. fiebre sin foco; 2. con foco
Localización: 1. Sepsis 2. Cutánea 3. Gastroenteritis 4. Neumonía 5. Urinaria 6. ORL 7. Catéter 8. Meningitis 9. Otros Germen 1. Bacteria 2. Virus 3. Hongo 4. Parásito Especificar germen
Nº Transfusiones Hematíes: Nº Transfusiones Plaquetas:
N* = límite alto de la normalidad N* = límite alto de la normalidad 1. Sí 2. No 1. Sí 2. No 1. Sí 2. No
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