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A child Vrabiy Maxim, date of birth – 13.07.05, residing at the address: 15 Glushkova Str., ap. 73, Kyiv, is currently undergoing treatment on an inpatient basis in oncohematology department, where he has stayed since 29.12.08 till now, with the diagnosis: acute lymphoblastic leukemia, common-ALL, with CNS affected (left orbit, articular process of lower jaw, maxillary sinuses, ethmoid air cells, nasal cavity, nasopharynx, facial bones, partially - skull base, temporal region of medullary substance), the 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(9;22) (the specimens have been consulted in St. Anna Children’s Hospital, Vienna).

The patient has been treated according to the protocol ALL-BFM-2000 since 29.12.08. On 33-th day of the therapy, bone marrow remission has been reached – 3.4% blasts. Head CT data: residual tumor mass still persists. No tumor mass in central nervous system (CNS) was detected during control examination performed following termination of protocol I (31.03.09). During chemotherapy course according to protocol I, a 10-day interval occurred at phase I due to tonoclonic spasms episode (a single one, dated 21.01.09), febrile neutropenia, and development of pulpitis of lower 5-th tooth on the left. During phase II, a 7-day interval in chemotherapy occurred due to febrile neutropenia and dental abscess of teeth 4, 5 below on the right. The therapy according to protocol I ALL-BFM 2000 was terminated on 19.03.09.

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(9;22), 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.