Pädiatrie und Therapeutik
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Congenital Acute Lymphoblastic Leukemia: A Rare Presentation in a One Month Old Boy

Hafiz MG*,Khaleque MA

A one month old boy of non-consanguineous parents was admitted with gradual distension of abdomen, yellow coloration of whole body, progressive pallor and respiratory distress since birth. Septic investigations were done and found negative. His complete blood count with peripheral blood film examination revealed hyperleukocytosis, thrombocytopenia and presence of significant number of blasts cell. Cerebrospinal fluid (CSF) examination showed central nervous system (CNS) status 3(≥5 WBC/cmm3 with blasts). Other causes of leukemoid reaction were ruled out. Karyotyping had done and found normal chromosomal pattern (46XY). Bone marrow aspiration findings were suggestive of ALL-L1.His myeloperoxidase (MPO) and Sudan black stain was negative but Periodic acid schiff (PAS) stain was positive. Immunophenotype showed blasts cells which were positive for CD5(1.10%), CD8(0.4%), CD10(0.74%), CD13(13.7%) and CD19(62.4%). Finally, the boy was diagnosed as congenital acute lymphoblastic leukemia (ALL-L1, B-lineage, CNS status 3). Following chemotherapy, the child suddenly deteriorated and on the second day of therapy suddenly he expired possibly due to leukostasis or coagulopathy or non responsive of drugs or MLL gene translocation.So, congenital acute lymphoblastic leukemia (CALL) should be kept in mind in a newborn child with clinical features of sepsis, leukocytosis, thrombocytopenia, huge hepatosplenomegaly.