Abstract
Perinatal leukaemia is a rare disorder and extensive cytochemical, morphological and immunological studies have not been carried out in most of the earlier cases. We report four cases of perinatal leukaemia with clinical, morphological, cytochemical, immunological and cytogenetic correlations. Two had acute lymphoblastic leukaemia (ALL) and the other two had acute myeloblastic leukaemia (AML). The age at diagnosis was 5 hours, 9, 34 and 64 days. Initial hemoglobin values ranged from 5.5 gm/dl to 14 gm/dl. WBC counts varied from 60,000/mm3 to 666,000/mm3. In the two with ALL the lymphoblasts were B antigen positive null cell type (Blood 49:371, 1977). Three had normal karyotypes in the marrow cells before treatment. In the fourth a 46XX, 18 P-karyotype was noted with the father showing 46XY t (18p; 10p). Three patients died at 5, 47 and 223 days after diagnosis. One, who had AML, and who is the male member of a dizygotic pair of twins, is alive and disease free 14 years after diagnosis. Our observations indicate that the reported higher incidence of AML in neonates should be more carefully verified. Similar to ALL in somewhat older age groups of children, null cell B antigen +ve ALL appears to be the common phenotypic expression of ALL in neonates. Exchange transfusion was found to be useful in reducing the immediate risk of metabolic and leukostatic complications. In addition, the disease free survivor indicates that long term remission is possible in perinatal leukaemia.
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Warrier, R., Ravindranath, Y., Inoue, S. et al. 886 PERINATAL LEUKAEMIA. Pediatr Res 15 (Suppl 4), 590 (1981). https://doi.org/10.1203/00006450-198104001-00911
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DOI: https://doi.org/10.1203/00006450-198104001-00911