Case 45-1981: A 15-Year-Old Girl with Leukemia, Fever, and Neurologic Changes

Presentation of Case A 15-year-old right-handed girl was admitted to the hospital because of neutropenia and fever. A heart murmer was heard in early childhood and was ascribed to pulmonic stenosis. She was otherwise well until 4 1/2 years before entry, when a diagnosis of acute lymphoblastic leukemia without B-cell or T-cell markers was made. The administration of vincristine and prednisone was followed by a complete remission, but a single injection of L-asparaginase provoked an allergic reaction. Radiation in a dose of 2400 rad was given to the cranium, and six intrathecal doses of methotrexate were administered; cytologic examination of . . .