[Atypical presentation of acute myeloblastic leukemia in two pediatric patients].
Acute myeloblastic leukemia (MLA) is an uncommon disease in childhood and its prognosis is worse than that of lymphoblastic leukemia. Severe hemorrhage, infections and perfusion disorders secondary to leukostasis are the main complications leading to its high mortality rate. Two pediatric patients with MLA (M5a and M2) are presented. Both patients were admitted to the pediatric intensive care unit with acute respiratory distress syndrome and intracranial hemorrhage respectively, secondary to leukostasis. The first patient showed favorable clinical course and underwent bone marrow transplantation four months later; in contrast, the second patient died a few hours after admission. The physiopathology of each case, the therapeutic approach and the use of leukopheresis as a therapeutic alternative in patients with hyperleukocytosis and leukostasis are discussed. A high degree of suspicion is required to make a diagnosis as early as possible in order to avoid the death of a large percentage of patients before cytostatic treatment begins.
Pérez Navero
J L
JL
Unidad de Cuidados Intensivos Pediátricos, Servicio de Críticos y Urgencias Pediátricas, Hospital Universitario Reina Sofia, Cordoba, Spain.
Marroquín Yáñez
L
L
Ibarra De La Rosa
I
I
Gómez García
P
P
D000293:Adolescent; D016026:Bone Marrow Transplantation; D001921:Brain / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000601:surgery; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D014057:Tomography, X-Ray Computed