A Case Study of Child with Acute Lymphoblastic Leukemia Treated in Intensive Care

The most common childhood cancer is acute lymphoblastic leukemia, which, thanks to medical progress, achieves up to 95% of complete remission and 80% of cures with appropriate treatment among patients diagnosed with ALL.

A less than three-year-old boy treated for an infectious disease and progressively worsening symptoms was transferred by the Emergency Department to the Department of Hematology and Oncology of Children after revealing leukocytosis and thrombocytopenia. In a short time, the child’s condition deteriorated, and it was decided to transfer the patient to the Children’s Intensive Care Unit. Due to respiratory failure, the boy was intubated, and mechanical ventilation was started. Catecholamines and sedatives were introduced. Due to increasing edema and anuria, diuretics were administered without diuresis. Hemodialysis was used. In spite of transfused group compatible blood products and exchange transfusion, coagulation disorders occurred. On the tenth day of hospitalization in the intensive care unit, the procedure of confirming brain death was performed.

Both the prevention and treatment of hyperleukocytosis syndrome and the development of treatment methods do not reduce the risk of this syndrome among children diagnosed with acute lymphoblastic leukemia. The determination of permanent and irreversible cessation of brain function is possible only after the proper execution of the procedure for determining brain death.