Case Report
 
Acute myeloblastic leukemia in neonate
Bagus Ngurah Mahakrishna1, Ketut Ariawati1
1Department of Child Health, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar-Bali

Article ID: 100004Z19BM2018
doi: 10.5348/100004Z19BM2018CR

Corresponding Author:
Bagus Ngurah Mahakrishna
Denpasar-Bali-Indonesia

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How to cite this article
Mahakrishna BN, Ariawati K. Acute myeloblastic leukemia in neonate. J Case Rep Images Pediatr 2018;1:100004Z19BM2018.


ABSTRACT

Introduction: Congenital leukemia is defined as leukemia that develops intra uterine. It is an extremely rare malignancy associated with poor prognosis and a poorly understood natural history. Incidence reported to be 1 per-5 million neonates. Acute myeloblastic leukemia is more common than acute lymphoblastic leukemia in neonate. Clinical signs of neonatal leukemia among various patients such as hepatosplenomegaly, enlarged lymph nodes, leukemia cutis, and hyperleukocytosis.

Case Report: We present a 6-days-old female neonate, referred to Sanglah Hospital with respiratory distress and lethargy. We found her with high breathing effort and fever. Physical examination found hepatomegaly. Laboratory examinations showed hyperleukocytosis (leucocyte count 140.000/mm3), anemia (hemoglobin 12.56 g/dL), normal thrombocytes count (245.400/mm3), and other laboratories within normal limits. Peripheral blood smear showed erythrocyte with normocytic normochromic, normoblastemia, leucocytes with elevated white blood cell count, immature white blood cells (blasts) as appeared in acute leukemia. Leukemia phenotyping showed myeloid lineage with aberrant expression CD 7 appropriate to acute myeloblastic leukemia. We diagnosed the patient with acute myeloblastic leukemia. Patient got hydration intravenously in order to prevent leukostasis syndrome. We planned a chemotherapy protocol.

Conclusion: Acute myeloblastic leukemia in neonate is a rare case. It was fetal form of malignant diseases with various clinical presentation such as high breathing effort and hyperleukocytosis. Its exact cause is still not fully understood. Congenital leukemia has a poor prognosis with an overall survival rate only 20% at 2 years of age.

Keywords: Acute myeloblastic leukemia, Hyperleukocytosis, Malignancy, Neonate


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Author Contributions
Bagus Ngurah Mahakrishna – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ketut Ariawati – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Consent Statement
Written informed consent was obtained from the patient for publication of this case report.
Conflict of Interest
Author declares no conflict of interest.
Copyright
© 2018 Bagus Ngurah Mahakrishna et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.