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MINISTRY OF HEALTH OF UKRAINE

"OHMATDYT" UKRAINIAN PEDIATRIC SPECIALIZED HOSPITAL

 

Extract from case history No 255

 

A child Zamsha Eva Kostyantynivna, date of birth – 21.11.07, residing at the address: 28 A Lesya Ukrainka Blvd., ap. 159, Kyiv, is currently undergoing treatment on an inpatient basis in oncohematology department, where she has stayed since 05.12.08, with the diagnosis: acute lymphoblastic leukemia, FAB-L1, pro-B-ALL with CD15 and CD65 coexpression, CNS 1 status, first acute period, high risk group.

The disease has been diagnosed on the basis of the aggregate of clinical-hematological data and examinations of bone marrow, liquor, and head CT. Cytogenetic examination of bone marrow blasts has revealed translocation t(4;11) (the specimens have been consulted in St. Anna Children’s Hospital, Vienna).

The patient has been treated according to the protocol LAA-BFM-2000 since 05.12.08. On 33-th day of the therapy, bone marrow remission has been reached – 0.6% blasts. A 6-day interval occurred during chemotherapy according to the protocol I due to febrile neutropenia. On 10.03.09, a consultation, including the head of Center of Pediatric Oncohematology and Bone Marrow Transplantation Donskaya S.B., the head of department of bone marrow transplantation Ryzhak O.A., the head of oncohematology department Kubalya N.A., and physicians of the department was carried out. The conclusion is as follows:

Considering high risk group of the patient and the presence of specific cytogenetic abnormality, translocation t(4;11), realization of the further therapy, comprised of 6 blocks of high dose therapy followed by allogenic transplantation from an alternative donor (non-relative HLA-compatible) during the first disease remission (due to the absence of a completely histocompatible donor in the family) is absolutely indicated.