UKRAINIAN MINISTRY OF HEALTH
UKRAINIAN SPECIALIZED CHILDREN’S CLINIC
„OKHMATDIT“
01135 Kiev Tel.: 236-6942
Chernovola 28/1 Fax: 236-6165
Epicrisis
of the Medical History of
Andriy Zharko, born on March 10, 2003
Res. at: Kiev, Kolomnevsky per. 7, apt. 32
Diagnosis: acute lymphoblast leucosis, early combined recurrence (bone marrow and CNS). 2nd acute period, therapeutic group S3.
First admission into the Department for Oncohematology on September 17, 2006, initial complaints about weakness and febrility. Child’s state at the beginning of treatment was bad due to intoxication / hyperblast syndromes. Results of the blood test’s at the time of admission: leucocytes 8,5 х 109 /l (52 % of blasts), Hb 77 g/l, platelets 8,5 х 109 /l. Exploratory punction of bone marrow showed total infiltration by lymphoblasts of the common type. Liquor exploration showed no blast cells. On the basis of all explorations carried out, the following diagnosis was concluded: acute lymphoblast leucosis, 1st acute period, standard risk group, CNS negative, common.
On September 20, 2006, polychemotherapy according to Protocol ALL-BFM 2000 was started. At the 8th day, the blast level in the peripheral blood was less than 1000/microl. On the 33rd day, complete hematologic remission was achieved.
The intensive chemotherapy was finished on May 06, 2007. The supportive therapy consisting of purinetol and metotrexat was carried out at our day patient facility until December 15, 2008.
Since January 10, complaints about febrility, bone ache and headache.
Bone marrow punktion on January 19, 2009. 58% of blast cells. Liquor exploration showed cytose of 2700/microl, great amounts of blast cells found. Diagnosis: acute lymphoblast leucosis, early combined (bone marrow and CNS), recurrence, 2nd acute period.
On January 21, 2009 therapy started according to Protocol ALL-REZ BFM 2002. Currently, 2nd ALL remission is achieved.
The family has been explored according to the HLA-System. No compatible family donor found.
Allogenic transplantation of bone marrow from an alternative donor indicated.
Head of Cneter for Diagnostics and Therapy (Signature) S.B. Donskaya
Head of Department for Oncohematology (Signature) N.A.Kubalya
(Clinic’s Seal) | 
