2.2.1 Children Eligible for Chemotherapy Administration in a Satellite Centre

Eligibility Criteria for Chemotherapy Administration in a Satellite Centre includes:

1. Children who have had a specific diagnosis established and whose treatment has been started on a defined protocol
2. It is strongly suggested that all patients referred to satellite care have central venous access to allow the safe administration of chemotherapy, particularly agents known to be vesicants. Difficulty with peripheral venous access is a contraindication to delivery of IV chemotherapy in the satellite context. 
3. For leukemia patients, eligibility for chemotherapy administration is contingent on evidence that bone marrow recovery from induction therapy
4. Patients whose chemotherapy protocols are out-patient-based;
5. Pediatric oncology patients requiring selected chemotherapy agents according to a specified route listed in Section 2.3 Scope of Satellite Practice.  The satellite centre must have adequate expertise to administer the agent and monitor for toxicity, and have the tertiary centre in agreement.
6. Children receiving oral chemotherapy started in the their tertiary centre may have these agents continued in a satellite centre. Furthermore, satellite centres may renew and adjust doses of oral chemotherapies such as corticosteroids, mercaptopurine and methotrexate in consultation and agreement with the referring tertiary centre. 
7. Children on high intensity protocols where the protocol specified therapy, at any time, falls within the individual agent guidelines, (e.g. Vincristine administration) or is deemed no more toxic than agents already specified as acceptable.
8. As new chemotherapy agents become available and are used on protocol, their toxicities and their appropriateness for use in the satellite context will be evaluated. New agents may then be added to the Table of Antineoplastic Agents approved for administration in the satellite context and suitable knowledge transfer undertaken.

Table – Chemotherapy Agents that can currently be Administered in the Satellite Context ^{1 2}

*Refer to patient’s protocol road map for additional monitoring requirements. Developed November 1994. Revised: April 1998, May 2001, October 2001, May 2002, December 2006, March 2015.

¹First dose of all antineoplastic agents in chemo naive patients need to be administered in the Tertiary centre.
²Refer to Extravasation protocol for agents classified as vesicants.
³Administration of cyclophosphamide may require an 8 hr day; if the satellite centre is not able to provide 8 hr monitoring, it should not be delivered. The ordering physician should also be available to respond to calls as appropriate.