Successful treatment of acute promyelocytic leukemia with initial hyperleukocytosis, differentiated syndrome and massive intracranial hemorrhage in a child
https://doi.org/10.35754/0234-5730-2024-69-2-236-246
Abstract
Introduction. The development of hemorrhagic syndrome at the onset of the disease in patients with acute promyelocytic leukemia (APL) is one of the main causes of therapy failures and the most common cause of death in the early stages of remission induction. The risk of severe hemorrhagic complications increases in patients with the microgranular APL variant, often accompanied with hyperleukocytosis.
Aim — to present a clinical case of successful diagnosis and treatment of primary APL with initial hyperleukocytosis in a patient with massive intracranial hemorrhage and differentiated syndrome.
Main findings. A clinical observation of the diagnosis and treatment of APL in a 13-year-old patient with initial hyperleukocytosis, massive intracranial hemorrhage and differentiation syndrome is presented. Data on the variable manifestations of hemorrhagic syndrome in patients with APL and its effect on survival outcomes are also given. Diagnostic criteria and approaches in the treatment of differentiation syndrome are presented on the example of a clinical observation, when early clinical diagnosis and timely initiation of special antitumor treatment in the intensive care unit made it possible to achieve clinical, hematological and molecular remission, avoiding the fatal consequences of massive intracranial hemorrhage.
About the Authors
S. V. Goryacheva
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Svetlana V. Goryacheva, Pediatric Oncologist of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 2
115478, Moscow
N. A. Batmanova
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Natalya A. Batmanova, Cand. Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 2
115478, Moscow
T. T. Valiev
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Timur T. Valiev, Dr. Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1
115478, Moscow
N. V. Matinyan
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center; Pirogov Russian National Research Medical University of the Ministry of Health of Russia
Russian Federation
Russian Federation
Nune V. Matinyan, Dr. Sci. (Med.), Head of the Department of Anesthesiology and Resuscitation; Professor of the Department of Pediatric Anesthesiology and Intensive Care of the FDPO
115478, Moscow
117997, Moscow
A. L. Kashanina
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Alexandra L. Kashanina, radiologist of the Department of pediatric X-ray diagnostics of the Research Institute of Pediatric Oncology and Hematology
115478, Moscow
D. S. Smirnova
Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Darya S. Smirnova, Pediatric Oncologist of the Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation
115478, Moscow
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Review
For citations:
Goryacheva S.V., Batmanova N.A., Valiev T.T., Matinyan N.V., Kashanina A.L., Smirnova D.S. Successful treatment of acute promyelocytic leukemia with initial hyperleukocytosis, differentiated syndrome and massive intracranial hemorrhage in a child. Russian journal of hematology and transfusiology. 2024;69(2):236-246. (In Russ.) https://doi.org/10.35754/0234-5730-2024-69-2-236-246
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