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[Clinical analysis of 144 cases of infant leukaemia]
Xianhao Wen1, Xianmin Guan, Ying Xian
1Department of Haematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Insights
Infant leukemia is a rare cancer with distinct features like hepatosplenomegaly and chromosome 11 abnormalities. Prognosis is poor, with chemotherapy remaining the primary treatment despite low remission rates.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Genetics
Background:
- Infant leukemia is a rare hematologic malignancy with unique clinical and genetic characteristics.
- Understanding its features is crucial for diagnosis and treatment strategies.
Purpose of the Study:
- To investigate the clinical manifestations, laboratory findings, and treatment outcomes of infant leukemia.
- To identify key prognostic factors and genetic abnormalities in this population.
Main Methods:
- Retrospective analysis of clinical data from 144 diagnosed cases of infant acute leukemia.
- Inclusion of data on patient demographics, clinical presentation, laboratory results, cytogenetic analysis, and MLL gene detection.
Main Results:
- Acute lymphoblastic leukemia (83 cases) and myeloid leukemia (55 cases) were most common.
- Hepatosplenomegaly (87.5%) and skin infiltration (in 6 patients <6 months) were frequent.
- Chromosome abnormalities, including t(4;11)/t(9;11)/t(11;19) and MLL gene fusions, were observed in a significant proportion of patients, particularly younger ones.
Conclusions:
- Infant leukemia presents distinct clinical features, often including hepatosplenomegaly and specific genetic abnormalities like MLL gene fusion and chromosome 11 alterations.
- The prognosis for infant leukemia remains unfavorable, with chemotherapy as the current standard treatment.
- Further research is needed to improve treatment efficacy and outcomes for this rare condition.
Objective:
To explore the clinical features, laboratory findings and treatment of infant leukemia.
Methods:
A retrospective analysis of the clinical data was performed of the cases with the diagnosis of infant acute leukemia from August 1993 to October 2014 in our hospital.
Results:
A total of 144 cases of infant leukemia were diagnosed in the defined period, including 83 cases of acute lymphoblastic leukemia, 55 myeloid leukemia, 1 hybrid acute leukaemia and 5 with incompatible cytological and immunophenotyping findings. The patients at the age of 9 to 12 months accounted for the largest proportion (38.2%), and 87.5% of the patients had hepatosplenomegaly; Six patients below 6 months old had skin infiltration. In about 1/3 of the patients, the white blood cells count was no greater than 100 × 10⁹ /L. Ninety-five patients had chromosome examinations, which identified chromosome abnormalities in 67 patients, including 18 positive for t(4;11)or t(9;11)or t(11;19), and younger patients were more likely to have chromosome abnormalities. Thirty-seven patients underwent MLL gene detection and 11 of them had positive results; the positive patients had higher rate of chromosome 11 abnormalities than the negative patients. Most of the patients gave up treatments after diagnosis and only 6 patients older than 6 months completed regular chemotherapeutic treatments and were now in complete remission.
Conclusion:
Infant leukemia is a rare type of leukemia with different clinical features from other types of leukemia. The patients often present with hepatosplenomegaly, high white blood cell counts, MLL gene fusion, and chromosome 11 abnormalities. The prognosis of infant leukemia is not favorable, and the current treatment still relies on chemotherapy.
