يك مورد لوكمي حاد با عوارض‌هاي متعدد ناشي از لوكمي و درمان آن: گزارش موردي

a case of acute leukemia with multiple complications due to leukemia and it's treatment: case report

زمينه و هدف: لوكمي حاد يكي از شايعترين سرطان‌هاي دوران كودكي است به‌طوري‌كه حدود يك چهارم سرطان‌هاي اين دوران را تشكيل مي‌دهد. لوكمي لنفوبلاستيك حاد با تكثير غيرطبيعي سلول‌هاي لنفوييد باعث ايجاد علايم حادي مي‌شود كه در صورت عدم درمان مناسب منجر به مرگ فرد مي‌شود. تشخيص اين نوع سرطان‌ها به‌راحتي با بررسي سلول‌هاي مغز استخوان و سلول‌هاي خون محيطي امكانپذير مي‌باشد. يكي از مكان‌هاي اوليه درگيري در لوكمي حاد در كودكان حفره دهاني مي‌باشد كه باعث علايم و نشانه‌هاي بيماري به‌صورت بروز ضايعات دهاني، تورم و خونريزي لثه در بيمار مي‌گردد. معرفي ‌بيمار: در اين مقاله دختر 13 ساله با لوكمي حاد معرفي مي‌شود كه به‌دليل درد دندان و پيدايش ضايعات در لثه تحت بيوپسي قرار مي‌گيرد و تشخيص لوكمي مورد تاييد قرار مي‌گيرد. نتيجه‌گيري: باوجود پيشرفت در درمان لوكمي و افزايش ميزان بقاي بيماران، موربيديته همچنان قابل توجه مي‌باشد.

Background: Acute leukemia is one of the most common types of childhood malignancies and one fourth of malignancies in this age group is acute leukemia. Acute leukemia may be myeloid or lymphoid. Acute lymphoblastic leukemia is characterized with abnormal proliferation of lymphoid cells and symptoms related to this are acute and if disease is not treated appropriately, it progresses rapidly and end up to death. Diagnosis of these types of malignancies is easily made with evaluation of bone marrow and peripheral blood cells by an expert hematologist. One of the primary sites of leukemic involvement in childhood is oral cavity which is caused by infiltration of leukemic cells in this area. This causes signs and symptoms, for instance, oral lesions gingival hemorrhage and swelling. Case presentation: We present a 13-year-old girl who was referred to local physician due to toothache and gingival lesions. Some medications were prescribed for her without any improvement. Then excision of this painful gingival lesion was done and diagnosis of acute lymphoblastic leukemia was confirmed. After diagnosis and start of appropriate medical therapy, patient developed many different complications of acute lymphoblastic leukemia and its related therapies. What make this presented case as an outstanding and interesting one is the mentioned complications which were more significant with multiple organ involvement in comparison with similar cases. These complications were treated by appropriate managements. Conclusion: With new advance in treatment of ALL, survival rate of patients is increased but unfortunately morbidity rate is significant. These complications may be managed by appropriate therapies and close follow-up.