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Images/Videos in Hematology
ARTICLE IN PRESS
doi:
10.25259/JHAS_52_2023

An unusual cause of breath-holding spell in a leukemic infant: Cytarabine

Department of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
Corresponding author: Zühre Kaya, Department of Pediatric Hematology, Gazi University School of Medicine, Ankara, Turkey. zuhrekaya@gazi.edu.tr
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Kirkiz Kayalı S, Topuz Türkcan B, Kaya Z. An unusual cause of breath-holding spell in a leukemic infant: Cytarabine. J Hematol Allied Sci. doi: 10.25259/JHAS_52_2023

A previously healthy 14-month-old female infant was diagnosed with leukemia. She was in complete remission following induction chemotherapy of the Interfant-06 protocol. Her complete blood count was within normal limits. After the first four cytarabine infusions, she developed a fever, palmar erythema, and edema [Figure 1]. Chemotherapy was discontinued. Cellulitis was suspected, and thus, broad-spectrum antibiotics were started. Her complaint was alleviated. When cytarabine infusion was restarted, fever, bilateral palmar erythema, edema, breath-holding spells, and cyanosis were observed [Video 1]. Her electroencephalogram revealed no abnormalities. All of these findings have been attributed to secondary cytarabine. Both immediate and delayed hypersensitivity reactions to cytarabine have been reported.[1,2] For allergic reactions, 1 mg/kg methylprednisolone plus antihistamine was administered before cytarabine infusion. All symptoms disappeared. She completed the chemotherapy protocol.

Figure 1
Palmar erythema and edema in an infant.

Video 1: Breath-holding spell in a leukemic child video is accessible from the portal.

Based on a literature search, the breath-holding spell in a leukemic child caused by cytarabine has been documented for the 1st time.

Ethical approval

The Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript, and no images were manipulated using AI.

Videos available on:

https://dx.doi.org/10.25259/JHAS_52_2023

Financial support and sponsorship

Nil.

References

  1. , , , , . Successful administration of cytarabine after a previous anaphylactic reaction. Allergy. 1997;52:1009-11.
    [CrossRef] [PubMed] [Google Scholar]
  2. , . Hypersensitivity reaction to high-dose cytarabine. Br J Haematol. 1989;73:274-5.
    [CrossRef] [PubMed] [Google Scholar]

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