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Re: PATIENT'S RECORD



Hi chi. Va^n

Chi. Va^n co' bie^'t hai o^ng ba\ Le^ Tho^'ng Nha^'t va\ NHU PHUONG MAI
na\y kho^ng? Tha^'y ba?o cu~ng ho.c MGU ra, cu\ng qua~ng Truong Gia Binh
(?) 
Hai o^ng ba\ na\y co' con bi. be^.nh ma'u tra('ng ddang muo^'n gu+?i ddi
Ta^y
ddie^\u tri.


----------
> De : Tran Van Hai <tvhai@hanoi.vnd.net>
> A : Multiple recipients of list <vnsa-l@csd.uwm.edu>
> Objet : PATIENT'S RECORD
> Date : mercredi 25 juin 1997 05:56
> 
> INSTITUTE FOR PROTECTION            Hosp. Code:121935
> OF CHILD HEALTH                 Date of admission: May 4th,1997
> 
> DEPARTMENT OF HEMATOLOGY
>      AND ONCOLOGY
> 
>                      PATIENT'S  RECORD
> 
> 
> Name    : LE  PHUONG  LIEN
> Date of birth   : 11 years old
> Sex     : Female
> Nationality     : Vietnamese
> Present address : No. 82, Quan Thanh Street, Ba Dinh District, Hanoi
> -Vietnam
> Father  : LE  THONG  NHAT       Age: 40
> Occupation      : Professor of Hanoi University. Doctor of Chemistry
> Mother  : NHU PHUONG MAI        Age: 41
> Occupation      : Professor of Hanoi University of Technology. Doctor of
> Math.
> 
> HISTORY OF GROWTH AND DEVELOPMENT
> 
> At birth        : First pregnancy of the mother
>           Normal delivery
>           Birth weight: 2 700 g
> Number of children of family: 1
> Physical growth and mental development: Normal
> Vaccination     : Full of programme
> 
> HISTORY OF DISEASE
> 
> Six days before admission of hospital the child was suffering from:
>         - Moderate fever
>         - Tiredness
>         - Pale
>         - Hemorrhage on skin
> Treatment before admission: Not any
> 
> PHYSICAL FINDINGS
> 
> 1. General status       : Fever 38oC, Tiredness
>           Weight: 32 kg,        Height: 134 cm
> 2. Skin and mucous      : Pale, some petechies and ecchymosis on trunk
> and
> extremities.
> 3. Muscle and skelete   : Normal
> 4. Lymphe nodles        : Enlarged submaxilar
> 5. Spleen       : Splenomegalia, 2 cm below costal
> 6. Liver        : Not enlarged
> 7. Respiratory system   : Normal
> 8. Cardio - vascular system     : Not findings of abnormal
> 9. Gastro - intestinal system   : Colite and melena
> 10. Uro - genital system        : Normal
> 11. CNS and mental status       : Normal
> 12. Other signs and symptoms: Not findings
> 
> LABORATORY EXAMINATION
> 
> Hemogramme at admission ( April 29th, 1997)
> * Hemoglobin                    11g/100ml
> * Hematocrit                    30%
> * Erythrocytes                  3.750.000/mm3
> * WBC                   13.700/mm3
>    Neutrophil segment           14%
>    Monocytes                    2%
> * Lymphocytes           23%
> * Lymphoblast                   61%  ()
> * Platelet                      30.000/mm3  ()
> 
> - Myelogramme at admission ( May 4th, 1997)
> Number of cells in bone marrow: Normal
> Lymphoblast     : 82%
> Lymphocyte      :   5%
> Neutrophil segment      :   3%
> Erythroblast    :   0%
> Megacaryocyte   : No
> Cerebro - Spinal Fluid  : Normal
> Transaminaza - GOT      : 17.5 U/l
>                        - GPT    : 42 U/l
> 
> CLINICAL DIAGNOSIS
> 
> Acute Lymphoblastic Leukemia (ALL)
> Type:  L1 (after FAB Classification) with High Risk.
> TREATMENT
> 1.Induction therapy
> -Chemiotherapy:
>         Vincristin 1.5mg, IV on May 4,11, 26
>                              on June 2, 9, 16
>         Adriamycine 30mg, IV on the same days with Vincristin
>         Prednison 50mg, on May 4 . June 11th
> - Leucomax (GM.CSF) on May 11 . 22
> - Blood transfusion
> - Antibiotic therapy
> - Acid folic
> 2. CNS prophylaxie therapy
>         Methotrexate 10mg intrathecal on May 4, 12, 26...
> 3. Follow up during induction therapy:
> - On 4 th May, 1997
>         Hb      : 90g/l
>         Hematocrit      : 26%
>         WBC     : 3.3 x 109 /l
>                 Neutrophil segment: 69%
>                 Monocyte        :  1%
>                 Lymphocyte      : 28%
>                 Lymphoblast     : 2%
>         Platelet        : 30 x 109 /l
> - On 6 th May 1997
>         Hb      : 80g/l
>         WBC     : 2.1 x 109 /l
>                 Neutrophil segment: 70%
>                 Lymphocyte      : 30%
>                 Lymphoblast     : 0%
>         Platelet        : below 50 x 109 /l
> 
> - On 12 th May 1997
>         Hb      : 80g/l
>         WBC     : 0.98 x 109 /l
>                 Neutrophil segment: 64%
>                 Monocyte        :  4%
>                 Lymphocyte      : 32%
>         Platelet        : 50 x 109 /l
> 
> - Stop of chemotherapy and GM.CSF therapy from May 11 . 22
> 
> - On 23 rd May 1997
>                 Hb      : 90g/l
>                 WBC     : 2.4 x 109 /l
>                 Neutrophil segment: 20%
>                 Monocyte        :  30%
>                 Lymphocyte: 50%
>         Platelet        : 120 x 109 /l
> 
> - Continued chemotherapy by Vincristine IV
>                                    Adriamycine  IV
>                                  Methotrexat    IT
> 
> - On 31 st May 1997
> 
>         Hb      : 100g/l
>         WBC     : 6.2 x 109 /l
>                 Neutrophil segment: 58%
>                Monocyte        :  5%
>                 Lymphocyte: 37%
>         Platelet        : 200 x 109 /l
> 
> - On 6 th June 1997
>         Hb      : 100g/l
>         Hematocrit      : 32%
>         WBC     : 7.4 x 109 /l
>                 Stab    : 3%
>                 Neutrophil segment: 74%
>                 Monocyte        :  5%
>                 Lymphocyte: 18%
>         Platelet        : 250 x 109 /l
>         Reticulocyte    : Blood: 2%
>                           Bone Marrow: 1.5%
> 
> Myelogramme:
>         Number of cells in bone marrow: 42 x  109 /l
>         Myelocyte       : 1%
>         Metamyelocyte   : 3%
>         Stab            : 6%
>         Neutrophil Segment: 42%
>         Lymphoblast     : 5%
>         Lymphocyte      : 39%
>         Erythroblast    : 4%
> Clinical findings: Moderate anemia only, no clinical signs
> 
> 4. Consolidation therapy will be from 18 June 1997 by L _ asparaginaza.
> 
> 
>                     Hanoi, June 12 th 1997
> 
> Head Department
> of Hematology and
> Oncology                                                
> (signed )
> Prof. NGUYEN Cong Khanh                                
> 
> 
> Physician
> (signed)
> Dr. Bui Ngoc Lan