24th February 2025

A 19-year-old patient with a germ cell tumour received inpatient chemotherapy on the oncology ward with bleomycin

A 19-year-old patient with a germ cell tumour received inpatient chemotherapy on the oncology ward with bleomycin, etoposide and cisplatin on Monday. You are asked to review him as routine blood tests performed one week later show: Hb 113 g/L, Haemotcocrit 0.40 l/L, MCV 80 fl, White cell count 0.7 x 10⁹/L, Neutrophils 0.3 x 10⁹/L, Lymphocytes 0.9 x 10⁹/L, Monocytes 0.1 x 10⁹/L, Eosinophils 0.1 x 10⁹/L, Platelet count 105 x 10⁹/L. Pre chemotherapy bloods were normal.

You review him clinically and he feels well in himself with no symptoms other than fatigue. Observations are as follows: HR 72 bpm, BP 134/72 mmHg, RR 16, oxygen saturations 98% on room air, temperature 38.1 degrees Celsius.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.