Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy.¹ Current survival rates for pediatric ALL are approaching 90% in the United States.^1,2 This has been accomplished by dose intensification, risk stratification, extended treatment duration, and central nervous system prophylaxis.^1,2

Granulocyte colony-stimulating factor (G-CSF) is often used after a hematopoietic stem-cell transplant (HSCT) to expedite neutrophil recovery after high-dose chemotherapy. Prolonged neutropenia after HSCT increases the risk for infectious complications and can contribute significantly to morbidity and mortality.^1-3

Scleroderma is a condition in which chronic inflammation and immune effects in the tissue lead to fibrotic changes caused by excess collagen and potentially vascular damage in the skin.^1,2 These immunologic changes lead to a hardening and thickening of various depths of the skin, which may have profound effects on a patient’s quality of life and requires complex medical management.^1,2

Clostridium difficile–related diarrhea is one of the most common types of nosocomial diarrhea in the United States, with an incidence of 15% to 25%.¹ Infectious diarrhea resulting from C difficile is a common complication in patients undergoing hematopoietic stem-cell transplant (HSCT), with higher rates in those undergoing allogeneic than autologous HSCT (12%-18% vs 6%-8.5%, respectively).^2-4