After a tentative diagnosis of leukemia, most physicians refer the family to the closest major children’s hospital for further tests and treatment. It is very important that children with leukemia be treated at a facility that uses a team approach, including pediatric oncologists, oncology nurses, pathologists, nurse practitioners, radiologists, psychologists, child life specialists, education specialists, and social workers. State-ofthe-art treatment is provided at these institutions, offering your child the best chance for remission (disappearance of the disease in response to treatment) and ultimately, cure.

When we were told that Katy had leukemia, for some reason I was worried that she would miss supper during the long road trip to Children’s Hospital. Why I was worried about this when she wasn’t eating anyway is a mystery. The doctor told us not to stop, just to go to a drive-through restaurant. I was so upset that I only packed Katy’s clothes; my husband, baby, and I had only the clothes on our backs for that first horrible week.

Usually, the child is admitted through the emergency room or the oncology clinic, where a physical exam is performed, an intravenous line (IV) is started, more blood is drawn, and a chest x-ray is obtained. Early in your child’s hospitalization, the pediatric oncologist will perform a spinal tap to determine whether any leukemia cells are present in the cerebrospinal fluid and a bone marrow aspiration to identify the type of leukemia. Details of these procedures are described in Chapter 9, Coping with Procedures.