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Appointment sheet: Leukaemia (all types)

One page to bring and write on: your details, the questions for Leukaemia (all types) plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Leukaemia (all types)

Prepared with OnCo (onco.cc/prep/leukaemia/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

12 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Flow cytometry immunophenotype, Cytogenetics and fusion genes, Mutations, Measurable residual disease by flow or PCR), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Diagnosis
  1. 5.For my situation (diagnosis), which of the standard options do you recommend and why?
Treatment
  1. 6.For my situation (treatment), which of the standard options do you recommend and why?
Supportive care
  1. 7.For my situation (supportive care), which of the standard options do you recommend and why?
Any stage
  1. 8.Are there clinical trials I could join, for example of Menin inhibitors, CAR-T cell therapy?
  2. 9.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 10.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 11.I read that “Adult ALL and TP53-mutated AML still have poor outcomes”. How does that affect my plan?
  5. 12.I read that “Infant and relapsed childhood leukaemias”. How does that affect my plan?

Tests and results to bring

Diagnosis: Blood count and film, bone marrow aspirate and biopsy, flow cytometry, cytogenetics and molecular panel; the subtype then sets the pathway.

Biomarker results to ask for: Flow cytometry immunophenotype, Cytogenetics and fusion genes (BCR-ABL1, PML-RARA, KMT2A), Mutations (FLT3, NPM1, IDH1/2, TP53, IGHV status), Measurable residual disease by flow or PCR.

Scans and tests linked to this cancer: Cytogenetics and FISH, Flow cytometers, Multiparameter flow cytometry MRD, TPMT and NUDT15 genotyping before thiopurines, Ex vivo drug sensitivity screening in blood cancers (EXALT).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call