Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · Oct 2009
Case ReportsChildhood Plasmodium vivax malaria with severe thrombocytopenia and bleeding manifestations.
Thrombocytopenia of varying magnitude, usually without hemorrhagic manifestations, is commonly observed in Plasmodium falciparum and Plasmodium vivax malaria. However, severe thrombocytopenia associated with bleeding manifestations in malarial infection is distinctly unusual. ⋯ He improved with antimalarial and intravenous immunoglobulin therapy. Clinicians caring for children should be aware of potential bleeding manifestations that may be the result of apparently innocuous infection like vivax malaria.
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J. Pediatr. Hematol. Oncol. · Oct 2009
Multicenter Study Comparative StudyEvaluation of the effects of different transfusion trigger levels during the treatment of childhood acute lymphoblastic leukemia.
Differences in the triggering levels for red blood cell (RBC) and platelet (PLT) transfusions were analyzed in association to the amount and total costs of transfusions and the number of febrile episodes during childhood acute lymphoblastic leukemia (ALL) treatment. Transfusions are given with hemoglobin (Hb) < or =90 to 100 g/L and PLT count < or =20 to 30 x 10(9)/L in Tampere, and with Hb < or =80 g/L and PLT count < or =10 x 10(9)/L in Turku. Median pretransfusion PLT count was 48 x 10(9)/L in Tampere, and 16 x 10(9)/L in Turku. ⋯ The number of febrile episodes was associated with the treatment protocol (P=0.03), and age at diagnosis (P=0.07). Lower trigger levels did not cause more delays or complications in treatment. Clinical trials are, however, necessary to determine optimal criteria for supportive blood transfusions in childhood cancer patients.