Emergencies in Acute Lymphoblastic Leukemia

A toddler with pallor and recurrent infection

“…Although many children are not critically ill at presentation, some present with a life threatening haematological complication precipitated by bone marrow failure. 7 On admission, haemoglobin can be as low as 30 g/l and high output heart failure secondary to profound anaemia can occasionally be fatal. Even before the adverse effects of chemotherapy on the integrity of the mucous membranes, neutropenia can lead to overwhelming sepsis, usually with Gram negative organisms, with or without disseminated intravascular coagulation.…”