Congenital Acute Leukemia

Abstract

Introduction: Congenital leukemia is a rare entity diagnosed between the time of birth and up to 4 to 6 weeks of life; it is of rapid evolution and poor prognosis. It is characterized by the presence of hepatomegaly, splenomegaly and hemorrhagic or infiltrative lesions on a newborn’s skin. The definitive diagnosis is made by a bone marrow aspirate study, in order to determine the phenotype of the leukemia. Transient myeloproliferative disorder and congenital infections are the main differential diagnoses. Treatment is based on multi-agent chemotherapy regimens that may achieve remission, but relapse rates remain high.

Objective: To describe two rare case presentations of acute congenital leukemia.

Case report: Two clinical cases of term newborns with congenital acute leukemia are presented: the first with mixed phenotype and the second with myeloid phenotype. Diagnosis, treatment and prognosis are discussed.

Conclusions: Two cases of acute congenital leukemia are presented, a rare disease with poor prognosis and about which little has been published in the literature. The present report highlights the importance of a thorough physical examination to guide the diagnostic suspicion. Currently, the prognostic factors of this disease have not been clearly defined, a reason why investigating associated factors is recommended, as well as establishing guidelines for early diagnosis and timely treatment.