Thomas was back in the hospital late last week and through the weekend so he could get high doses of a chemotherapy drug called cytarabine or ARA-C.  To say it’s ‘harsh stuff’ is an understatement.  Thomas is too weak to take video himself, so Lisa, his mom is doing it for him.

The following is a small sampling of the side-effects that kids like Thomas can expect to see after a dose of ARA-C:

Expected Reactions: Because cytarabine is a bone marrow suppressant,anemia, leukopenia, thrombocytopenia, megaloblastosis, and reduced reticulocytes can be expected as a result of administration of cytarabine. The severity of these reactions are dose and schedule dependent. Cellular changes in the morphology of bone marrow and peripheral smears can be expected.

Infectious Complications:Infection - Viral, bacterial, fungal, parasitic, or saprophytic infections, in any location in the body may be associated with the use of cytarabine alone or in combination with other immunosuppressive agents following immunosuppressant doses that affect cellular or humoral immunity. These infections may be mild, but can be severe and at times fatal.

The Cytarabine (Ara-C) Syndrome: A cytarabine syndrome has been described by Castleberry. It is characterized by fever, myalgia, bone pain, occasionallychest pain, maculopapular rash, conjunctivitis, and malaise. It usually occurs 6 to 12 hours following drug administration. Corticosteroids have been shown to be beneficial in treating or preventing this syndrome. If the symptoms of the syndrome are deemed treatable, corticosteroids should be contemplated, as well as continuation of therapy with cytarabine.

Most Frequent Adverse Reactions
anorexia	hepatic dysfunction
nausea	fever
vomiting	rash
diarrhea	thrombophlebitis
oral and anal or ulceration	inflammation bleeding (all sites)

Nausea and vomiting are most frequent following rapid intravenous injection.

Less Frequent Adverse Reactions
sepsis	bowel necrosis
pneumonia	abdominal pain
cellulitis at injection site	freckling jaundice
skin ulceration	conjunctivitis (may occur with rash)
urinary retention	dizziness
renal dysfunction	alopecia
neuritis neural toxicity	anaphylaxis (See “WARNINGS”Section) -
sore throat	allergic edema
esophageal ulceration	pruritus
esophagitis	shortness of breath
chest pain	urticaria
	headache

But to Thomas and his family, it’s just another day-in-the-life of a teenager with leukemia.