• Agata Rocka, Magdalena Woźniak, Monika Lejman, and Joanna Zawitkowska.
• Pediatric Radiology, Medical University of Lublin, Lublin, Poland.
• Medicine (Baltimore). 2023 Sep 8; 102 (36): e34965e34965.

RationaleAcute lymphoblastic leukemia (ALL) represents approximately 1-quarter of all new cases of childhood cancer. Although overall survival following diagnosis has improved in recent years, the toxicity of chemotherapy remains a concern.Patient ConcernsWe describe an 11-year-old male patient diagnosed with T-cell precursor ALL who developed compounded complications during the induction phase of chemotherapy. Patient was hospitalized in the Department of Pediatric Hematology, Oncology, and Transplantology of the Medical University of Lublin, Poland. The patient's induction therapy was started according to the AIEOP-BFM ALL 2017 protocol IAp (International Collaborative Treatment Protocol for Children and Adolescents with Acute Lymphoblastic Leukemia).DiagnosesPatient developed compounded complications such as cholecystitis, hepatotoxicity, pancreatitis and myelosuppression.InterventionsThe patient was treated with leukapheresis, received a broad-spectrum antibiotic, potassium supplementation and hepatoprotective treatment and laparotomy cholecystectomy.OutcomesIn the available literature, there is a limited amount of similar clinical cases with multiple complications in pediatric patients with ALL. Toxicities cause delays in the treatment of the underlying disease.LessonsIn children with acute lymphoblastic leukemia, there are side effects during the treatment such as cholecystitis and pancreatitis. Complications during treatment require a quick response and modification of disease management. Abdominal ultrasound performed before treatment makes it possible to observe the dynamics of lesions. Genetic mutation analysis could allow us to more precisely respond to the possible susceptibility to and appearance of complications after the use of a given chemotherapeutic agent.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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