Diagnosis and Treatment-Related Complications of Acute Leukemia

Abstract

Children diagnosed with acute leukemia are challenged not only by the life-threatening disease itself but a myriad of potential lethal complications related to treatment, some of which can result in end-organ dysfunction requiring pediatric intensive care unit (PICU) management. Such complications of leukemia treatment and/or the disease itself range from hyperleukocytosis and tumor lysis syndrome to typhlitis, pancreatitis, and serious coagulopathies. It is important that healthcare providers caring for children and adolescent patients with acute leukemia can recognize these potential complications in order to appropriately triage and manage them. As the overall survival for children with acute leukemia continues to improve, research has focused on novel strategies to further decrease the burden of therapy and lower the rates of toxic death while maintaining these very good outcomes. This chapter provides an overview of some of the more common oncologic emergencies occurring in children with acute leukemia that may require PICU care, focusing on the diagnosis and management.