Acute lymphoblastic leukemia (ALL) in a neonate can have a similar clinical appearance to other serious pathology and should be considered in the ill-appearing infant. We present the case of a 24-hour-old male infant born to a mother with limited prenatal care who was brought to the pediatric emergency department with a rash and decreased movement. ⋯ Cytogenetics showed a complex t (9;19;11) translocation, indicating a diagnosis of neonatal ALL. Given the morbidity and mortality rate among infants with neonatal ALL, his parents elected not to pursue cancer-directed therapy in favor of symptomatic care.
Rachel Oliver, Andrew L Juergens, Derek Hatch, Dominic Lucia, and Melissa DeLario.
From the Texas A&M Health Science Center, Bryan.
Pediatr Emerg Care. 2020 Feb 1; 36 (2): e102-e103.
AbstractAcute lymphoblastic leukemia (ALL) in a neonate can have a similar clinical appearance to other serious pathology and should be considered in the ill-appearing infant. We present the case of a 24-hour-old male infant born to a mother with limited prenatal care who was brought to the pediatric emergency department with a rash and decreased movement. His initial white blood cell count was 822 × 10 cells/L. Cytogenetics showed a complex t (9;19;11) translocation, indicating a diagnosis of neonatal ALL. Given the morbidity and mortality rate among infants with neonatal ALL, his parents elected not to pursue cancer-directed therapy in favor of symptomatic care.