• Caution patient to avoid crowds and persons with known infections. Health care professional should be informed immediately if symptoms of infection occur.

• Instruct patient to report unusual bleeding. Advise patient of thrombocytopenia precautions.

• These drugs may cause gonadal suppression; however, patient should still use birth control, as most antineoplastics are teratogenic. Advise patient to inform health care professional immediately if pregnancy is suspected.

• Discuss with patient the possibility of hair loss. Explore methods of coping.

• Instruct patient to inspect oral mucosa for erythema and ulceration. If ulceration occurs, advise patient to use sponge brush and to rinse mouth with water after eating and drinking. Topical agents may be used if mouth pain interferes with eating. Stomatitis pain may require treatment with opioid analgesics.

• Instruct patient not to receive any vaccinations without advice of health care professional. Antineoplastics may decrease antibody response and increase risk of adverse reactions.

• Advise patient of need for medical follow-up and frequent lab tests.