Chapter 26 Clinical Manifestations and Treatment of Acute Lymphoblastic Leukemia in Children
|Symptoms and Signs||Etiology||Management|
|Fever||Disease or infection||Always conduct fever workup and provide broad antimicrobial coverage until infectious etiology is ruled out|
|Fatigue, pallor||Anemia (ALL infiltrating BM)||RBC transfusion (slow if anemia is severe; avoid in hyperleukocytosis)|
|Petechiae, bruising, bleeding||Thrombocytopenia (ALL infiltrating BM)||Transfuse with platelets|
|Pain||Leukemia infiltrating bones or joints or expanding BM cavity||Establish diagnosis and start chemotherapy|
|Respiratory distress, superior vena cava syndrome||Mediastinal mass||Avoid sedation in the presence of tracheal compression; establish diagnosis as soon as possible and start chemotherapy|
ALL, Acute lymphoblastic leukemia; BM, bone marrow; RBC, red blood cell.