Summary: In last 8 years 283 children with acute leukemia or MDS were treated in our department. ARDS developed in 13 cases of children treated for hematologic malignity, it represents 4,6% of all children.There were 7 children treated for AML, 5 for ALL, 1 for MDS.
Clinical symptoms of ARDS were: tachypnea, dyspnea, partial respiratory insufficiency and intersticial lung changes on chest X - ray. Together with ARDS the febrile neutropenia was present in all cases.
Most patients developed ARDS as a consequence of induction chemotherapy. In 6 patients bolus of steroids was given.
Mechanical ventilation needed 11 of the patients. Five children died, all with the diagnosis AML.
ARDS resolved in 6 ventilated and 2 nonventilated patients. Incidence of ARDS seems to increase with the use of more agressive chemotherapy.