ABSTRACT
We describe a newborn infant who was born with a purpuric rash and subcutaneous nodules. Skin biopsies demonstrated acute myeloid leukemia. Cytogenetic studies revealed an 11q23 rearrangement. Initial bone marrow and cerebrospinal fluid examination did not demonstrate medullary or meningeal disease. Chemotherapy was initiated on the basis of the abnormal cytogenetic findings in the skin biopsy. Intensive chemotherapy was, given but the infant's leukemia progressed. The patient died of refractory leukemia and secondary fungal disease. This case report supports the observation that leukemia cutis with an 11q23 rearrangement should be treated aggressively.
Subject(s)
Leukemia, Myeloid/pathology , Leukemia/pathology , Acute Disease , Antineoplastic Agents/therapeutic use , Biopsy , Fatal Outcome , Female , Humans , Infant, Newborn , Leukemia/congenital , Leukemia/drug therapy , Leukemia, Myeloid/drug therapyABSTRACT
Extramedullary acute myeloid leukemia (AML) is not uncommon. It has been shown to involve the kidneys in most postmortem cases but is most often clinically insignificant. By contrast, acute tumor lysis syndrome is rare in AML, especially at initial diagnosis. The authors report the management of a patient with AML who had acute tumor lysis syndrome that was probably potentiated by renal leukemia and resulted in renal failure. This patient achieved remission with dose-modified induction chemotherapy administered while he was dialysis-dependent.
