Immuno-hematological analysis of Congenital AML associated with Downs Syndrome

Abstract

Congenital leukemia is very rare, diagnosed in first month of life and often associated with Downs syndrome. Congenital Acute myeloid leukemia (AML) is more common over acute lymphoblastic leukemia (ALL). The hematological parameters such as anemia, low hematocrit, reduced RBC count, reduced platelets are distinct characteristics against normal parameters in very closely associated Transient myeloproliferative disorder (TMD). The immunophenptypic markers such as expression pattern of CD13, CD11b and HLADR in combination can be used for distinguishing two diseases. The morphological discrimination between congenital AML and TMD is little difficult and hence combined results of hematological, cytogenetic and immunophenotyping should be considered while concluding the cases. We here report two cases observed in year 2014 in our hospital, at pune. Both the cases were diagnosed in first week of their life, day 2 (case 1) and day 8 (case2) with distinct features of increased white blood cell count with myeloid blast, reduced Hb, low hematocrit, reduced RBC count and low platelets count with trisomy 21. Both the cases were CD13- and CD11b +, hence we conclude these cases as Congenital Acute myeloid leukemia associated with Downs syndrome. Both the cases survived for less than 15 days after the birth.