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[Cutaneous symptoms revealing a monoblastic leukemia]
Summary
Leukemia cutis (LC) can be an early sign of acute myeloid leukemia (AML) in infants, but this case highlights a poor prognosis despite initial remission. Early skin relapse and disease progression led to a fatal outcome.
Area of Science:
- Pediatric Oncology
- Dermatology
- Hematology
Background:
- Leukemia cutis (LC), skin manifestation of leukemia, is uncommon as the initial presentation of acute myeloid leukemia (AML).
- While LC in AML is generally associated with a poor prognosis, its role as an initial presenting sign, particularly in infants, requires further investigation.
Observation:
- A case of an infant presenting with isolated leukemia cutis at the time of AML diagnosis is reported.
- The infant was diagnosed with acute myeloid leukemia M5 subtype, with bone marrow aspiration confirming the diagnosis.
Findings:
- Initial treatment with the LAME 91 protocol achieved complete remission in both bone marrow and skin.
- However, early skin relapse occurred, and subsequent treatments, including autologous bone marrow transplantation and VP16, failed to induce sustained remission, leading to disease progression and bone marrow relapse.
Implications:
- This case underscores the challenges in managing infants with acute myeloid leukemia presenting with leukemia cutis.
- The rapid progression and refractoriness to treatment highlight the aggressive nature of the disease in this specific presentation and suggest a poor prognostic indicator.