Paediatric acute leukaemia: managing the first 24 hours.

Abstract

Acute leukaemia remains the most common cancer in childhood. Early recognition and appropriate investigation, as well as rapid identification and management of complications is key to securing the diagnosis and reducing the risk of early mortality. Given the frequency of acute leukaemia in children it is likely that a mid-sized hospital will encounter an average of three diagnoses per year. The first day of care for a newly diagnosed child with leukaemia is a significant management challenge for the paediatrician due to heterogeneous nature of presentation of leukaemia and the oncological emergencies that it can precipitate. Urgent and decisive intervention in these children is essential. This article is intended to be used by general paediatricians in secondary care as an aide to managing these patients before they are transferred to a Principal Treatment Centre. It covers essential initial management strategies and a comprehensive guide on management of oncological emergencies in children with newly diagnosed acute leukaemias.