A 16-month-old boy had been diagnosed with B-cell acute lymphoblastic leukemia (ALL). Past medical and birth histories were unremarkable. Over the past 48 hours, he received and tolerated a slow transfusion of packed red blood cells for an Hgb concentration of 4.9 g/dL (49 g/L). Currently, he is receiving maintenance intravenous hydration. Physical examination shows no evidence of distress. His temperature is 97.5°F (36.4°C), respirations are 24 breaths/min, heart rate is 126 beats/min, blood pressure is 95/64 mm Hg, and oxygen saturation is 98% on room air. His chest is clear to auscultation, with normal heart sounds. Abdominal examination shows mild hepatosplenomegaly. He has scattered petechiae. Current laboratory results are: WBC count of 14.8×103/mcL (14.8×109/L), Hgb of 10.4 g/dL (104 g/L), Hct of 28.9% (0.29), and platelet count of 48×103/mcL (48×109/L). The values for serum electrolytes, BUN, creatinine, liver enzymes, and uric...

You do not currently have access to this content.