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Transient blastemia in phenotypically normal newborns.

G R Jones, M Weaver, W E Laug

    The American Journal of Pediatric Hematology/Oncology
    |January 1, 1987
    PubMed
    Summary
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    Newborns with trisomy 21 (Down syndrome) and blastemia can spontaneously recover. Aggressive supportive care, avoiding cytotoxic drugs, is crucial for these infants with Down syndrome and blastemia.

    Area of Science:

    • Neonatal Hematology
    • Clinical Genetics
    • Pediatric Oncology

    Background:

    • Infants with trisomy 21 can present with hematological abnormalities.
    • Blastemia, the presence of immature blast cells, is a rare finding in newborns.

    Observation:

    • Two phenotypically normal newborns presented with elevated white blood cell counts and blastemia.
    • Karyotype analysis revealed trisomy 21 in all metaphases for both infants.
    • One infant required exchange transfusions and pericardiotomy; the other had persistent, subtle hematopoietic abnormalities.

    Findings:

    • Blastemia spontaneously resolved in both patients.
    • The percentage of trisomy 21 cells decreased over time.
    • Both children achieved normal growth and development despite initial findings.

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    Implications:

    • Highlights the importance of conservative management for newborns with trisomy 21 and blastemia.
    • Emphasizes supportive care over aggressive chemotherapy in this specific population.
    • Suggests that trisomy 21-associated blastemia may have a favorable prognosis with appropriate care.