Case Report On T-Cell Variant Lymphoblastic Luekemia

Abstract

ALL is a rare condition in which aberrant white blood cells build in the bone marrow and eventually replace normal white blood cells. Cell variant ALL is a kind of acute lymphoblastic leukemia characterized by a malignant bone marrow tumor.

Clinical Findings: Fever, Blood tinged vomiting (Hematemesis), Melaena, loss of appetite, active nasal bleeding, with generalized lymphadenopathy and massive hepatosplenomegaly.

Diagnostic Evaluation: Hb-6.8gm%, RBCs-2.36 millions/cu.mm, WBCs-400/cu mm, platelets-0.9 Lacs/cu mm, RDW-17.6%, HCT-20.7%.

Peripheral Smear: RBCs-Normocytic moderately hypochromic. Acute Lymphoblastic Leukemia (Type L₂).

CSF Examination: It shows only granular material sparse red blood cells and rare leucocytic nuclei and contaminants.

Ultrasonography: Splenomegaly

Therapeutic intervention: Blood transfusion, Inj. Ceftazidime 1.5gm, Inj. Amikacin 3.75mg, Inj. KCL 5ml, Inj. Pan 40mg, Inj. Emset 4mg, Inj. Neomol 750mg, Inj. Tramadol 45mg, Tab. Septron , Tab. Fluconazole 150mg, Tab. Zyloric Allopurinol 300mg, Tab. Augmentin 625mg, Tab. Allopurinol 300mg, Tab. Cetirizine 10mg, Tab. Zinc power, Tab. Limcee 500mg, Tab. Shelcal 500mg, Syrup. Zinconia 5ml, Syrup. Duphalac, Syrup. Mucainegel, Syrup. Sucralfate, Syrup. Cremaffin.

Chemotherapy:, Inj. Vincristine 2mg, Inj. Intrathecal Methotrexate12mg, Inj. L- Asparaginase (Leunase) 6000IU, Tab. Omnacortil 40mg.

Outcome: After treatment the child show improvement, the fever and Hematemesis were relieved. After 3 times of blood transfusion, the count shows Hb-9.4%, RBCs- 3.55 million/cu.mm, WBCs-1000/cu.mm.

Conclusion: The patient admitted to AVBRH under pediatric ward with a known case of T cell variant ALL Now, the patient condition is stable and he is under observation.