Division of Neonatology, Department of Pediatrics, Akdeniz University Medical School, Antalya, Turkey.
J Clin Pharm Ther. 2013 Jun;38(3):262-4. doi: 10.1111/jcpt.12058. Epub 2013 Mar 19.
Congenital leukaemia is the most common leukaemia in newborns with Down syndrome, but it must be differentiated from transient myeloproliferative disorder. The majority of transient myeloproliferative disorders regresses spontaneously during the first few months of life. Data on the treatment outcomes of transient myeloproliferative disorder in premature infants are very rare. We present a case of a very-low-birthweight (1350 g) premature newborn with Down syndrome, diagnosed as having transient myeloproliferative disorder and treated with chemotherapy due to recurrent hyperleucocytosis (WBC: 148 000/mm³) after repeated exchange transfusions.
The patient's WBC count regressed to 24 000/mm(3) without treatment. During the follow-up period, the WBC increased on consecutive days and reached 95 000/mm(3) on the 16th day of the hospitalization. Therefore, chemotherapy was started. Single-agent cytarabine infusion was administered over five days. After the therapy, the WBC count stayed stable and remained steady in the range 4600-13600/mm(3) in the second month.
A very-low-birthweight infant with Down syndrome and recurrent transient myeloproliferative disorder was successfully treated with cytarabine.
先天性白血病是唐氏综合征新生儿中最常见的白血病，但必须将其与一过性骨髓增生异常相区别。大多数一过性骨髓增生异常在生命的头几个月会自发消退。关于早产儿一过性骨髓增生异常治疗结果的数据非常罕见。我们报告了一例极低出生体重（1350g）的唐氏综合征早产儿，因反复换血后反复出现白细胞增多症（WBC：148000/mm³）而被诊断为一过性骨髓增生异常，并接受了化疗。
患者的白细胞计数在未治疗的情况下降至 24000/mm³。在随访期间，白细胞连续数日增加，住院第 16 天达到 95000/mm³。因此，开始化疗。单药阿糖胞苷输注持续五天。治疗后，白细胞计数稳定，在第二个月内保持在 4600-13600/mm³的范围内。
一例唐氏综合征极低出生体重儿伴复发性一过性骨髓增生异常，用阿糖胞苷成功治疗。
