Mansoor Neelum, Jabbar Naeem
Department of Hematology, The Indus Hospital, Karachi, Pakistan.
Department of Pediatric Hematology-Oncology, The Indus Hospital, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2022 Aug;32(8):S174-S176. doi: 10.29271/jcpsp.2022.Supp2.S174.
A high index of suspicion of acute leukemia in infants presenting with atypical clinical and laboratory features is of paramount importance to avoid the delay in diagnosis, and treatment of this rare, yet extremely aggressive entity. We report a case of a 10 months infant presenting with a one-month history of fever and restlessness along with complete blood count (CBC) findings of bicytopenia, borderline leukocytosis, leucoerythroblastic picture, and reactive lymphocytes. Considering infection, the patient was kept on antibiotics and symptomatic treatment. However, the persistence of findings led to bone marrow aspirate which revealed T-cell acute lymphoblastic leukemia (T-ALL) on flow cytometry. Infant ALL is almost B cell phenotype and T-ALL is hardly ever reported. Knowledge and recognition of these cases can help to improve awareness regarding consideration of this rare phenotype of leukemia irrespective of clinical presentation and age of the patient. Key Words: Acute lymphoblastic leukemia, Infant leukemia, Flow cytometry.
对于具有非典型临床和实验室特征的婴儿急性白血病保持高度怀疑指数，对于避免这种罕见但极具侵袭性疾病的诊断和治疗延迟至关重要。我们报告一例10个月大的婴儿，有1个月发热和烦躁不安病史，全血细胞计数（CBC）显示双血细胞减少、临界白细胞增多、幼粒-幼红细胞血象和反应性淋巴细胞。考虑到感染，患者接受了抗生素治疗和对症治疗。然而，这些检查结果持续存在，导致进行骨髓穿刺，流式细胞术显示为T细胞急性淋巴细胞白血病（T-ALL）。婴儿急性淋巴细胞白血病几乎都是B细胞表型，T-ALL很少见报道。认识和识别这些病例有助于提高对这种罕见白血病表型的认识，而不论患者的临床表现和年龄如何。关键词：急性淋巴细胞白血病、婴儿白血病、流式细胞术
