MINISTRY OF HEALTH OF UKRAINE
"OHMATDYT" UKRAINIAN PEDIATRIC SPECIALIZED HOSPITAL
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01135, Kyiv,
28/1 Chornovola Str.
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Tel.: 236-12-22
Fax: 236-61-65
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Extract from case history No 40
Gonchar Yuriy Sergiyovych, date of birth – 12.02.2004, residing at the address: 35 Pyatydesyatyrichhya SSSR Str., ap. 49, town of Kremenchug, Poltava oblast. The patient is undergoing treatment on an inpatient basis in intensive chemotherapy department of the Center of Pediatric Oncohematology and Bone Marrow Transplantation of "OHMATDYT" National Pediatric Specialized Hospital, where he has stayed since 28.08.2009 till now.
Diagnosis:
Acute lymphoblastic leukemia, the third (bone-marrow) relapse.
Common-variant (C 91.0).
Blood group: AB (IV), Rh positive.
Acute lymphoblastic leukemia has been first diagnosed in February 2007. The patient was treated according to the protocol ALL-IC BFM 2002 for moderate risk groups (Protocol I, Protocol mM, Protocol II) in Oblast Pediatric Clinical Hospital of Poltava city.
Supportive chemotherapy was initiated in January 2008.
The first neurological relapse occurred in February 2009.
The second neurological relapse occurred in July 2009. Systemic anti-recurrent therapy was not performed due to the parents’ rejection.
Liquor sanation was achieved by intrathecal administration of methotrexate, cytosar, and prednisolone in each neurological relapse episode.
The patient and his parents referred to the Center of Pediatric Oncohematology and Bone Marrow Transplantation of "OHMATDYT" National Pediatric Specialized Hospital in August 2009.
Myelogram data of 28.08.2009 revealed blast cell content 4.2%.
Cytomorphological examination of cerebrospinal fluid dated 31.08.2009: no blast cells were detected; cytosis – 0.
The situation has been considered the third (bone marrow) relapse according to MRD immunocytological evaluation.
Palliative chemotherapy according to the protocol II-IDA (ALL-REZ BFM 2002) has been initiated from 4.09.2009.
Due to the failure to achieve an essential result by chemotherapeutic means, the only curative treatment method in this case is allogenic transplantation of peripheral stem hemopoietic cells from an alternative donor.
This type of transplantation is not performed in Ukraine.
Recommendations: HLA-typing of the patient and his parents.
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Head of Center of Pediatric Oncohematology and Bone Marrow Transplantation of "OHMATDYT" NATIONAL PEDIATRIC SPECIALIZED HOSPITAL
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[Signature]
[Seal]:
Ministry of Health of Ukraine
Kyiv city
"OHMATDYT" NATIONAL PEDIATRIC SPECIALIZED HOSPITAL
Identification code 01994089
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S.B. Donskaya
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Head of intensive chemotherapy department
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[Signature]
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I.V. Stetsiuk
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Doctor in charge
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[Signature]
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S.L. Granatskaya
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09.09.2009 | 
