Validation of the English Social Attunement Questionnaire: Associations with Substance Use, Impulsivity, and Sensation Seeking across the Lifespan.

A 9‐year‐old boy was diagnosed with B‐cell acute lymphoblastic leukemia (B‐ALL) with an IKZF1 deletion 2 years prior to presentation and assigned to the high‐risk arm of the ALLTogether protocol, a European randomized treatment study for children and young adults with ALL that employs individualized risk stratification based on leukemia genetics and treatment response []. He underwent induction chemotherapy followed by consolidation therapy and maintenance therapy with methotrexate and 6‐mercaptopurine. He did not undergo allogeneic hematopoietic stem cell transplant (HSCT). While in maintenance therapy, he was receiving monthly intravenous immunoglobulins (IVIGs) for secondary hypogammaglobulinemia, and trimethoprim‐sulfamethoxazole (TMP‐SMX) prophylaxis, the latter of which had been discontinued in the weeks preceding presentation due to chronic diarrhea. Eighteen months after commencing maintenance therapy, the patient developed a fever without localizing symptoms. He was evaluated by a general practitioner while in Corsica, France, without identification of an infectious source. Given that his fever persisted beyond 7 days in the context of active hematologic malignancy treatment, he was admitted to the pediatric oncology‐hematology unit of CHU de Nice, France (Day 0). On admission, laboratory evaluation revealed pancytopenia and liver enzyme elevation (Table ). Initial microbiologic workup was unrevealing. Cross‐sectional imaging, including a CT scan of the sinuses, thorax, and abdomen and pelvis, as well as an abdominal ultrasound, was non‐revealing. A urine culture obtained at that time grew pan‐susceptible , though this was felt to be insufficient to explain his systemic clinical picture. A bone marrow aspirate (Day +1) showed no evidence of disease relapse.