Onkológia 2/2013

Congenital leukemia – difficulties in diagnostics and treatment

Purpose: Leukemia in neonates is rare and quite distinct from other childhood leukemias. We report two cases of neonates with clinical and laboratory leukemia symptoms with very different behaviour in terms of biology, treatment and prognosis Case: In the first case immediatly after delivery petechie were visible on head and on spine. On the 4th day severe trombocytopenia occured. In the second case neonate presented with leukemia cutis and hyperleucocytosis. In both cases nonmalignant causes were excluded and due to precise diagnosis and classification of leukemia transient myeloproliferative disease in the fist case and acute monoblastic leukemia in the second case were diagnosed. Results: In the first case we used „wait and watch“ approach and then we applied short and low dose chemotherapy. In the second case long and high intensity chemoterapy was necessary to apply. Both children are in the 1st complete remmision. Conclusion: Congenital leukemia is a rare malignancy in newborn without Down syndrome. Nonmalignant and other malignant conditions that mimic leukemia need to be differentiate. Due to current availability of precise leukemia diagnostic and classification it is possible to tailor optimal treatment and improve prognosis of the severe disease.

Keywords: congenital leukemia, transient myeloproliferative disorder, acute monocytic leukemia.