Passage / Scenario

Marie is a 5-year-old girl is admitted with a diagnosis of Acute Lymphoblastic Leukemia. She enters complete remission with intensive induction of chemotherapy, but she relapses after 3 months of maintenance of chemotherapy with vincristine, prednisone, methotrexate and mercaptopurine. She develops a neutropenia from the chemotherapy. On admission, her lab results came back with WBC 15000, Hemoglobin 8 mg/dl; platelet 94,000. She complains of ache all over her body, her gum bleeds very easily. Vital signs include BP 70/40; HR 130, RR 28; Temp 38°C