A Newborn with Congenital Mixed Phenotype Acute Leukemia After In Vitro Fertilization

Pediatr Neonatol. 2015 Aug;56(4):271-4. doi: 10.1016/j.pedneo.2013.03.016. Epub 2013 Apr 30.

Abstract

Congenital leukemia is a rare disease. The majority of cases of this disease are acute myelogenous leukemia (AML). Congenital acute lymphoblastic leukemia (ALL) is rare and most often is of B cell lineage. Rarely, some cases have been designated biphenotypic or mixed phenotype acute leukemia (MPAL). Herein, we report a preterm newborn referred to us as a result of the appearance of blue-violaceous dermal nodules on her body at birth. She was a twin and the product of an in vitro fertilization (IVF) pregnancy. Physical examination showed jaundice, hepatosplenomegaly, and peripheral facial nerve palsy in addition to dermal nodules. Bone marrow aspiration showed 40% blasts of lymphoid lineage; skin biopsy and its immunohistochemistry revealed myeloblastic infiltration of the dermis. Cytogenetic analysis (46,XX), fluorescence in situ hybridization (FISH) analysis, and cranial magnetic resonance were normal. The patient was diagnosed with congenital MPAL, and an association between IVF and congenital leukemia was suggested.

Keywords: congenital; in vitro fertilization (IVF); leukemia cutis; mixed phenotype acute leukemia (MPAL).

Publication types

  • Case Reports

MeSH terms

  • Diseases in Twins / genetics*
  • Diseases in Twins / immunology
  • Female
  • Fertilization in Vitro / adverse effects*
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • In Situ Hybridization, Fluorescence
  • Infant, Newborn
  • Infant, Premature
  • Leukemia, Biphenotypic, Acute / congenital*
  • Leukemia, Biphenotypic, Acute / immunology
  • Skin Neoplasms / congenital*
  • Skin Neoplasms / immunology