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Pediatr Emerg Care. 2020 Feb;36(2):e102-e103. doi: 10.1097/PEC.0000000000001956.

Neonatal Acute Lymphoblastic Leukemia.

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From the Texas A&M Health Science Center, Bryan.
Baylor Scott & White Health - Temple, Temple, TX.
United States Air Force Academy, El Paso County, CO.


Acute lymphoblastic leukemia (ALL) in a neonate can have a similar clinical appearance to other serious pathology and should be considered in the ill-appearing infant. We present the case of a 24-hour-old male infant born to a mother with limited prenatal care who was brought to the pediatric emergency department with a rash and decreased movement. His initial white blood cell count was 822 × 10 cells/L. Cytogenetics showed a complex t (9;19;11) translocation, indicating a diagnosis of neonatal ALL. Given the morbidity and mortality rate among infants with neonatal ALL, his parents elected not to pursue cancer-directed therapy in favor of symptomatic care.

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