This case report describes the management of an 11-year-old boy diagnosed with Acute Lymphoblastic Leukemia (ALL) in 2012. The patient was referred to Dr. Sujata Vasani after being initially diagnosed in Dubai, he was then admitted to a hospital in Mumbai for treatment.
History:
The patient presented with complaints of weakness, loss of appetite, fever and body ache since a week. His blood tests showed a high white blood cell count, with reduced hemoglobin and platelets, with 90% blasts in the peripheral smear, indicating an Acute Leukemia.
Investigations:
The patient underwent a thorough evaluation including routine blood tests, a cardiac evaluation, and a full body scan to rule out underlying infection. A bone marrow aspiration and biopsy confirmed the diagnosis of B cell Lymphoblastic Leukemia. Further testing with Immunohistochemistry, Cytogenetics, FISH studies, Karyotyping, and Histopathology was also performed to verify the diagnosis.
Concerns:
The patient and his family were counseled regarding the disease, treatment options, potential side-effects, and prognosis. The parents were understandably terrified, but Dr. Sujata reassured them that treatment options existed and that childhood ALL had high cure rates.
Treatment Offered:
The patient was started on intensive high-dose chemotherapy, oral steroids, and intrathecal injections for CNS protection. The patient attained remission after the first month of induction and completed the entire chemotherapy protocol in six months. Following the completion of intravenous chemotherapy, the patient was started on oral maintenance therapy. He completed his treatment in 2013. He was then monitored closely over the next 10 years.
Long-Term Care:
The patient currently remains in remission in 2023, and is followed up regularly by Dr. Sujata with periodic blood counts and scans. He remains in good health, he is now 22 years old and leading a normal life. This case study emphasizes the importance of long-term follow-up for patients with ALL to detect and treat any potential relapse, and also illustrates that childhood leukaemia can be cured with timely and appropriate treatment.