Biochemical analysis of blood (21/03/12)

Bilirubin was 12-2-10 mol/l, urea - 3.3 mmol/l, total protein - 77 g/l, glucose - 5.20 mmol/l, alanine aminotransferaza - 34 U/l, aspartate aminotransferase - 27 U/l, kreatinin was 75 mkmol/l, with no cholesterol, calcium - 2.19 mmol/l, sodium - 141 mmol/l, potassium - 4.2 mmol/l, chloride - 106 mmol/l, serum iron - 34.9 umol/l.

Urinalysis (07/02/2012)

Specific gravity: 1010, no protein; no glucose, 0-1 leukocytes have been detected in the field of view of microscope, no red blood cells have been detected in the field of view of the microscope, no bacteria has been detected.

ECG: vertical position of the electrical axis of heart.

Treatment: Considering the lack of remission after a "7 +3" course,  during this hospitalization  a course of chemotherapy has been carries out according to the scheme HAM № 1 (intravenously): Cytosar 3 g x twice a day during the period from 22/03/2012 to 24/03/2012, and 12 g 26/03/2012. Mitoxantrone 20 mg for the period from 26/03/2012 to 27/03/2012, and 10 mg 28/03/2012.

The therapy has been carried out against a background of detoxification therapy, on day 2 of the course body temperature rose up to 38,5 ° C, antibiotic therapy (Tienam 500 mg 3 times a day) was initiated on the background of the treatment profound cytopenia (WBC 0.2, platelets 3.0, hemoglobin 69 g/l) has been marked, antibiotic (Tienam 500 mg 3 times a day) component-replacement therapy was carried out (administration of red cell and platelet concentrates); on the 20th day after completion of therapy progressive blastemia (0% at the level of white blood cells 0.7) was signed, with thrombocytopenia without hemorrhagic syndrome persistsing. After several transfusions anemia  was arrested (with the level of hemoglobin 86 g/l).

The status of the patient at discharge (16/04/2012): hemoglobin 86 g/l, platelets 50.0. White blood cells: 0.7, blasts10%, stab1%, segmented 1%, lymphocytes 9%, monocytes 3%, basophils 1%. The erythrocyte sedimentation rate was 54 mm/hour. Normoblastosis was 8:100L.

At the strong request of the patient, she has been discharged to the place of residence under the watch of a physician.

The tactics of the subsequent treatment will be determined 7-10 days later, after the check of blood analysis.

It is recommended to discharge the patient and continue taking the following drugs:

1.                  Ciprofloxacin 250 mg twice daily for 7 days.

2.                  Dicynone 2 tablets 3 times a day, every day.

Attending physician: Glazunova V. V. <signed>

Head of the department: Huazheva N. K. <signed>

<A round doctor's personal seal: GLAZUNOVA Valerya Viktorovna>