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[Neonatal acute leukemia: apropos of 7 cases]
I Cumin1, F Mechinaud-Lacroix, H Avet-Loiseau
1Service d'oncologie pédiatrique, hôpital Mère et Enfant, Nantes, France.
Background:
Acute leukemia in neonates is rare and is more severe than leukemia in childhood.
Population:
Seven cases (four girls, three boys) were included in this series. Leukemia was diagnosed at birth in three cases; hepatosplenomegaly was seen in five cases and skin nodules in three. Hyperleukocytosis more than 100,000/mm3 was present in four cases; the WBC and differential counts were normal in two. A meningeal involvement was seen in one case. The leukemia was lymphoblastic (ALL) in three cases and myeloblastic (AML) in four. Intensive chemotherapy induced complete remission in five patients, persisting 5 and 4 years after the diagnosis in two. Classic risk factors such as high white blood counts, central nervous system involvement, myeloblastic lineage, absence of CALLA (common acute lymphoblastic leukemia antigen) expression and abnormal blast cell karyotype interesting the 11q23 area were found again in this series. Risk related to drug toxicities and infectious complications were also noted in this series of very young patients.
Conclusions:
The outcome may depend on progress in pharmacology, search for new drugs and use of bone marrow transplantation.