婴儿白血病是一种罕见的血液癌症,在生命的第一年内表现出来。这种恶性肿瘤具有高度侵袭性,并具有独特的免疫表型,细胞遗传学,和分子属性。它可以起源于髓样或淋巴样细胞。它通常在女性中表现出更高的发病率。
■1个月大的男婴,最初看起来很健康,表现出烦躁和喂养困难。出生时没有并发症,常规新生儿评估似乎正常,体格检查没有异常。然而,实验室检测显示白细胞计数极高,低血小板,血红蛋白升高.进一步的检查显示白细胞计数为1450×106/l,血膜显示出以原始细胞为主的显着白细胞增多。腹部超声证实肝脾肿大在怀孕期间不存在。随后的骨髓分析和流式细胞术确定了B细胞急性淋巴细胞白血病(B-ALL)的诊断。
■婴儿ALL在出生后的第一个月内很少出现。在大多数情况下,诊断是在出生前确定的。当特征性体征如肝脾肿大时,皮肤白血病,或者存在髓外和中枢神经系统的浸润性受累,产后诊断相对简单.然而,在某些情况下,儿童出现类似于其他疾病的非特异性和模棱两可的症状。
这个案例强调了儿科医生保持警惕和调整细微指标的重要性,这些指标可以将常见疾病与婴儿ALL等严重疾病区分开来。
UNASSIGNED: Infantile leukaemia is an uncommon haematological cancer that manifests within the first year of life. This malignancy is highly aggressive and possesses distinctive immunophenotypic, cytogenetic, and molecular attributes. It can originate from either myeloid or lymphoid cells. It often exhibits a higher incidence among females.
UNASSIGNED: A 1-month-old male infant, initially seemingly healthy, presented with irritability and feeding difficulties. Born without complications, routine neonatal assessments appeared normal, and physical examination revealed no abnormalities. However, laboratory tests indicated an extremely high white blood cell count, low platelets, and elevated haemoglobin. Further examinations showed a white blood cell count of 1450 × 106/l with a blood film revealing significant
leukocytosis dominated by blast cells. Abdominal ultrasound confirmed hepatosplenomegaly which was not present during pregnancy. Subsequent bone marrow analysis and flow cytometry established a diagnosis of B-cell acute lymphoblastic leukaemia (B-ALL).
UNASSIGNED: It is rare for infantile ALL to manifest within the first month after birth. In most cases, the diagnosis is established before birth. When characteristic signs such as hepatosplenomegaly, leukaemia cutis, or infiltrative involvement of the extramedullary and central nervous systems are present, postnatal diagnoses are relatively straightforward. However, there are instances where children present with non-specific and ambiguous symptoms that resemble other medical conditions.
UNASSIGNED: This
case underscores the importance of paediatricians being vigilant and attuned to the subtle indicators that differentiate common illnesses from serious conditions such as infantile ALL.