A Case of Congenital Leukemia The 6 th Case Reported in Japan

Abstract

1. A case of congenital myelogenous leukemia diagnosed on 22 nd day of birth was described. The clinical picture began with subcutaneous and umbilical hemorrhages. Fever remained slight through the whole course.
2. Hematologically there were a number of peculiar features: The case presented no anemia and no acceleration of sedimentation rate. Platelets, however, decreased to a count of 74, 000, bleeding time being prolonged to 17 minutes and coagulation time also prolonged considerably. The white count was between 100, 000 and 150, 000 and myeloblasts were of 72.5% of the count at the commencement. Peroxidase reaction was negative in 80% of the myeloblasts and remained so up to the death. Eosinophiles and basophiles increased in number.
3. Marrow examination showed that myeloblasts occurred in 74.8% of all cells. The other features of the marrow morphology was more or less reflexed in the blood picture
4. All the Japanese cases of congenital leukemia hitherto reported were tabulated, our own case being the 6 th one.
5. Our own case was principally treated with ACTH and blood trans-fusion, but no remission occurred. The patient died with dyspnoea and increasing cyanose on the 33 rd day of birth.