Which of the following explains why ibuprofen should be avoided in a child with leukemia?

• A. It can prolong bleeding time
• B. It reduces tumor response
• C. It interferes with antibiotics
• D. It increases white blood cell production

Answer: (A)

Ibuprofen should be avoided in a child with leukemia because it can prolong bleeding time by inhibiting platelet function. As a nonsteroidal anti-inflammatory drug, it blocks an enzyme (cyclooxygenase) needed to produce thromboxane A2, which helps platelets clump together to form clots. In leukemia, platelet counts are often low, so further impairment of platelet function raises the risk of bleeding from even minor injuries or mucous membranes. The other statements don’t reflect how ibuprofen works: it does not reduce tumor response, not generally interfere with antibiotics, and does not increase white blood cell production. For fever or pain in this setting, acetaminophen is a safer alternative because it does not impair platelet function.