Clinical context An adult with B-cell precursor acute lympho… | MyMerci
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Clinical context An adult with B-cell precursor acute lymphoblastic leukemia develops fever, hypotension, hypoxemia, confusion, word-finding difficulty, and tremor 18 hours after a continuous blinatumomab infusion begins, raising concern for concurrent cytokine release syndrome and neurologic toxicity. Highlight the new findings that support simultaneous cytokine release syndrome and neurologic toxicity during blinatumomab therapy. Do not select stable baseline or unrelated findings.

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Infusion Record\nA 46-year-old client with B-cell precursor acute lymphoblastic leukemia with normal orientation and language before treatment began continuous blinatumomab infusion 18 hours ago. The client now has temperature 39.3 C, blood pressure 82/48 mm Hg, oxygen saturation 89% on room air, new confusion, difficulty naming common objects, and a new hand tremor. The blood glucose is 104 mg/dL, and the pupils are equal and reactive.
Infusion Record\nA 46-year-old client with B-cell precursor acute lymphoblastic leukemia with normal orientation and language before treatment began continuous blinatumomab infusion 18 hours ago. The client now has temperature 39.3 C, blood pressure 82/48 mm Hg, oxygen saturation 89% on room air, new confusion, difficulty naming common objects, and a new hand tremor. The blood glucose is 104 mg/dL, and the pupils are equal and reactive.
Explanation
High fever, hypotension, hypoxemia, new confusion, a speech disturbance, and a new tremor after blinatumomab begins are urgent cues for cytokine release syndrome with neurologic toxicity.
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