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PP-058 Postchemotherapy complications in a child with acute lymphoblastic leukemia
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  1. Singer Cristina Elena1,
  2. Cosoveanu Carmen Simona1,
  3. Singer Maria2,
  4. Popescu Mihaela3,
  5. Popescu Alin4,
  6. Geormaneanu Cristina5
  1. 1University of Medicine and Pharmacy Craiova, 2nd Pediatric Clinic, Emergency County Hospital Craiova, Romania
  2. 2resident doctor, Bucharest Military Hospital, Romania
  3. 3Endocrinology Clinic, University of Medicine and Pharmacy in Craiova, Romania
  4. 4Medical Clinic, University of Medicine and Pharmacy in Craiova, Romania
  5. 5Emergency Department, University of Medicine and Pharmacy in Craiova, Romania

Abstract

Aim We present the case of an 11-year-old patient, diagnosed in September 2023 with B-Cell acute lymphoblastic leukemia, to whom induction chemotherapy was initiated according to the ALL IC-BFM 2002 protocol, with complete remission on day 33, undetectable minimal residual disease.

Material and Method He is readmitted in October 2023: normal clinical examination; biological: leukopenia, neutropenia, secondary grade 1 anemia, thrombocytopenia.

Results It presents fever, chills, with the repetition of fever. The general condition remains affected, pale, plantar edema, vesicular breathing sounds harsh, high fever persists. Antibiotic treatment, fluid and electrolytic infusion, red blood cell and platelet transfusions are instituted. It presents hypoproteinemia, hypokalemia, blood culture - staphylococcus aureus. Echocardiogram: FEVS 50%, mitral and tricuspid regurgitation secondary to pulmonary hypertension, heart failure class III NYHA. He receives cardiological treatment. In evolution, the patient presents with acute staphylococcal pneumonia (MRSA culture). Gradually the general condition is improving, the cardio-respiratory normal and the cytostatic treatment is repeated.

Conclusions During hospitalization, she received intensive supportive treatment, the patient presenting a septic state, heart failure, staphylococcal pneumonia with acute respiratory failure, hydro-electrolytic, biochemical imbalances, anemia, neutropenia, thrombocytopenia, which required treatment with multiple antibiotics for 2 months.

  • acute lymphoblastic leukemia
  • postchemotherapy complications
  • children

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