Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve
A 10-year-old girl with trisomy 21 and complex congenital heart disease presented with acute lymphoblastic leukemia. Her chemotherapy required modifications due to poor baseline cardiac status and a mechanical prosthetic heart valve that was dependent on anticoagulation. We describe our management i...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2012/193093 |
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| author | Saima Alvi Evan Shereck Manraj K. S. Heran George G. S. Sandor Shahrad Rod Rassekh |
| author_facet | Saima Alvi Evan Shereck Manraj K. S. Heran George G. S. Sandor Shahrad Rod Rassekh |
| author_sort | Saima Alvi |
| collection | DOAJ |
| description | A 10-year-old girl with trisomy 21 and complex congenital heart disease presented with acute lymphoblastic leukemia. Her chemotherapy required modifications due to poor baseline cardiac status and a mechanical prosthetic heart valve that was dependent on anticoagulation. We describe our management including the use of low-molecular-weight heparin as anticoagulation for a mechanical heart valve, the safe delivery of intrathecal chemotherapy included bridging with unfractionated heparin, and the use of fluoroscopic guidance to minimize the risk of bleeding. Adjustments were made to avoid anthracyclines. The child tolerated therapy well without complications and remains relapse free five years after diagnosis. |
| format | Article |
| id | doaj-art-a640f7d203d94600af8398fa811632d6 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-a640f7d203d94600af8398fa811632d62025-02-03T01:03:03ZengWileyCase Reports in Pediatrics2090-68032090-68112012-01-01201210.1155/2012/193093193093Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic ValveSaima Alvi0Evan Shereck1Manraj K. S. Heran2George G. S. Sandor3Shahrad Rod Rassekh4Division of Pediatric Oncology, Hematology and BMT, Department of Pediatrics, British Columbia’s Children’s Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, CanadaDepartment of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USADivision of Pediatric Interventional Radiology, Children’s and Women’s Health Center of British Columbia, University of British Columbia, Vancouver, BC, V6H 3V4, CanadaDivision of Pediatric Cardiology, Department of Pediatrics, British Columbia’s Children’s Hospital, University of British Columbia, Vancouver, BC, V6H 3V4, CanadaDivision of Pediatric Oncology, Hematology and BMT, Department of Pediatrics, British Columbia’s Children’s Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, CanadaA 10-year-old girl with trisomy 21 and complex congenital heart disease presented with acute lymphoblastic leukemia. Her chemotherapy required modifications due to poor baseline cardiac status and a mechanical prosthetic heart valve that was dependent on anticoagulation. We describe our management including the use of low-molecular-weight heparin as anticoagulation for a mechanical heart valve, the safe delivery of intrathecal chemotherapy included bridging with unfractionated heparin, and the use of fluoroscopic guidance to minimize the risk of bleeding. Adjustments were made to avoid anthracyclines. The child tolerated therapy well without complications and remains relapse free five years after diagnosis.http://dx.doi.org/10.1155/2012/193093 |
| spellingShingle | Saima Alvi Evan Shereck Manraj K. S. Heran George G. S. Sandor Shahrad Rod Rassekh Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve Case Reports in Pediatrics |
| title | Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve |
| title_full | Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve |
| title_fullStr | Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve |
| title_full_unstemmed | Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve |
| title_short | Successful Treatment of Acute Lymphoblastic Leukemia in a Child with Trisomy 21 and Complex Congenital Heart Disease with Mechanical Prosthetic Valve |
| title_sort | successful treatment of acute lymphoblastic leukemia in a child with trisomy 21 and complex congenital heart disease with mechanical prosthetic valve |
| url | http://dx.doi.org/10.1155/2012/193093 |
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