UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 19 / No. 3 / Published : 2013-01

Order : 13, and page :211 - 217

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Original Article :

Neonatal acute myeloid leukaemia

Author :

  1. Luh Putu Rihayani Budi*1
  2. Ketut Ariawati*2
  3. Sianny Herawati*3
  1. Departments of Child Health and Clinical Pathology
  2. Departments of Child Health and Clinical Pathology
  3. Udayana University/Sanglah Hospital Denpasar Bali

Abstract :

Acute myeloid leukaemia (AML) is a. malignant, clonally disease that involves proliferation of blasts in bone marrow, blood, or other tissue. The blasts most often show myeloid or monocytic differentiation. The incidence of AML increases with age, but when neonatal leukaemia does occur, it is paradoxically AML rather than ALL. All the signs and symptoms that present on patient with AML are caused by the infiltration of the bone marrow with leukaemic cells and resulting failure of normal haematopoiesis. Without the normal haematopoietic elements, the patient is at risk for developing life-threatening complications of anaemia, infection due to functional neutropenia, and haemorrhage due to thrombocytopenia. Organomegaly is seen in approximately half of patient with AML due to hepatic and sphlanic infiltration with leukaemic blasts. Prognosis of neonatal leukaemia is poor with the 6-month survival rate is only one third despite aggressive chemotherapy. It has higher mortality rate than any other congenital cancer. The researchers reported two of AML diagnosed cases in neonatal period. The first case, a one-day-old male was referred with respiratory distress and suspect Down syndrome with spontaneous petechiae. The second case, a 17-day-old female presented with bloody diarrhoea and history of hypothyroid. Dysmorphic face and hepatosplenomegalia were found in both of the physical examination. Their complete blood count revealed leukocytosis and thrombocytopenia. Peripheral blood smear revealed myeloblast 30% on the first case and 23% on the second case. Both immunophenotyping revealed the population of blast expressing myeloid lineage (CD33 and CD34).     Leukemia mielositik akut (LMA) adalah keganasan sel darah yang ditandai dengan ploriferasi sel blast dengan diferensiasi mieloid atau monositik di sumsum tulang, darah tepi, dan jaringan lainnya. Angka kejadian LMA meningkat dengan bertambahnya usia, namun pada masa neonatus angka kejadian LMA lebih tinggi dibandingkan LLA. Gejala yang muncul pada pasien dengan leukemia diakibatkan oleh infiltrasi sumsum tulang oleh sel-sel leukemia yang mengakibatkan gagalnya hematopoiesis normal. Gagalnya hematopoiesis menyebabkan pasien menjadi berisiko untuk mengalami anemia, infeksi berat akibat neutropenia, dan perdarahan akibat trombositopenia. Infiltrasi sel-sel blast pada hati dan lien menyebabkan terjadinya organomegali pada organ-organ tersebut (hepatosplenomegali). Neonatus dengan leukemia memiliki perjanana penyakit yang buruk dengan angka keselamatan selama 6 bulan hanya sepertiga walaupun dengan menjalani kemoterapi. Leukemia pada masa neonatus memiliki angka kematian yang lebih tinggi dibandingkan dengan keganasan kongenital lainnya. Kami melaporkan dua kasus LMA pada masa neonatus. Kasus pertama adalah laki-laki usia satu hari yang dirujuk dengan distress napas dan kecurigaan Sindrom Down dengan petekiae spontan. Kasus ke dua adalah perempuan berusia 17 hari yang datang dengan keluhan diare berdarah dengan riwayat hipotiroid sebelumnya. Wajah yang dismorfik dan hepatosplenomegali ditemukan pada kedua neonatus tersebut. Pemeriksaan darah tepi pada keduanya menunjukkan leukositosis dan trombositopenia, sedangkan hapusan darah tepi menunjukkan mieloblast sebanyak 30% pada kasus pertama dan 23% pada kasus ke dua. Pemeriksaan fenotip imonologis yang dilakukan pada kedua neonatus tersebut menunjukkan populasi sel blast yang mengekspresikan petanda mieloid (CD33 dan CD 34).

Keyword :

Neonatal, acute myeloid leukaemia,


References :

Heffner LT,(2007) Acute myeloid leukemia USA : The McGraw-Hill companies

Kean LS, Arceci RJ, Woods WG,(2006) Acute myeloid leukemia Massachusetts : Blackwell Publishing Ltd

Felix CA, Lange BJ,(1999) Leukemia in infants USA : The Oncologist

Caldwell B,(2007) Acute leukemias Philadelphia : Davis Company

Clark JJ, Berman JN, Look AT,(2009) Myeloid leukemia, myelodysplasia, and myeloproliferative disease in children Philadelphia : Saunders





Archive Article

Cover Media Content

Volume : 19 / No. : 3 / Pub. : 2013-01
  1. {(active Caspase-3 In Acute Myeloid Leukaemia (aml) And Acute Lymphoblastic Leukaemia (all)}
  2. (principle Modification Of β-glucan Detection From Candida Albicans In Serum)
  3. Apoptosis Index Between Females And Males In Regular Hemodialysis
  4. [iron Deficiency In Pregnant Women By Haemoglobin Reticulocyte (ret-he)]
  5. (higher Level Of Ctx In Osteoporotic Women Compared To Normal And Osteopenic Women)
  6. (cystatin C, Hba1c And Albumin Creatinine Ratio)
  7. (lactate Dehydrogenase (ldh) During Storage)
  8. (cd4+ T Lymphocyte As A Prognosis Predictor In Sepsis Patients)
  9. (angiotensin Ii On Adipocytes Culture Exposed With High Glucose)
  10. (the Panleucogating Method For Lymphocyte Cd4 Counting In Hiv Patients)
  11. (c3c Serum Complement And Blood T-cd4+ Lymphocyte)
  12. (cell Based Hemostatis – In Vivo)
  13. Neonatal Acute Myeloid Leukaemia

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