Contributions
Abstract: PB1376
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
The coincidence of acute lymphoblastic leukaemia (ALL) and hemophilia is extremely rare in pediatric age group.
Aims
We report the 1st case in Greece with severe haemophilia A diagnosed in a child with ALL.
Methods
A 2,5 year old boy admitted to our Unit due to generalized weakness and episodes of severe nose bleeding for the last month. Family history revealed that boy’s uncle (mother’s brother) suffered from haemophilia A. From physical examination, paleness, petechiaes and ecchymoses were noticed, as well as, organomegaly. Peripheral blood count showed hemoglobin level of 5.6 g%, white cell count of 212 × 109/L (blasts 95%), and platelet count of 16 × 109/L. Activated partial thromboplastin time (APTT) found very high, but prothrombin time (PT) not.
Results
Bone marrow aspiration-immunophenotype confirmed the diagnosis of B-II (common) ALL. RT-PCR for genetic alterations BCR abl, AF-4/MLL and TEL-AML1 found negative. CSF was also negative for blastic cells. Following the placement of central venous catheter prolonged bleeding was noticed. Prolonged APTT and family history led to the possibility of hemophilia which finally diagnosed from laboratory tests (FVIII levels <1%). The patient was placed on induction therapy for ALL, according to ALLIC 2009 protocol, and FVIII replacement. On day 33 of treatment, the patient achieved complete remission. He finished successfully the first 6 months of treatment and he will hopefully continue on maintenance phase of the protocol.
Conclusion
The most common haemorrhagic disorder in children with leukaemia is disseminated intravascular coagulation (DIC). The diagnosis of haemophilia A is very rare and there is no clear therapeutic plan in such cases, but timely diagnosis should not be delayed and proper treatment should be based on clinical findings.
Keyword(s): Acute lymphoblastic leukemia, Hemophilia A, Pediatric
Abstract: PB1376
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
The coincidence of acute lymphoblastic leukaemia (ALL) and hemophilia is extremely rare in pediatric age group.
Aims
We report the 1st case in Greece with severe haemophilia A diagnosed in a child with ALL.
Methods
A 2,5 year old boy admitted to our Unit due to generalized weakness and episodes of severe nose bleeding for the last month. Family history revealed that boy’s uncle (mother’s brother) suffered from haemophilia A. From physical examination, paleness, petechiaes and ecchymoses were noticed, as well as, organomegaly. Peripheral blood count showed hemoglobin level of 5.6 g%, white cell count of 212 × 109/L (blasts 95%), and platelet count of 16 × 109/L. Activated partial thromboplastin time (APTT) found very high, but prothrombin time (PT) not.
Results
Bone marrow aspiration-immunophenotype confirmed the diagnosis of B-II (common) ALL. RT-PCR for genetic alterations BCR abl, AF-4/MLL and TEL-AML1 found negative. CSF was also negative for blastic cells. Following the placement of central venous catheter prolonged bleeding was noticed. Prolonged APTT and family history led to the possibility of hemophilia which finally diagnosed from laboratory tests (FVIII levels <1%). The patient was placed on induction therapy for ALL, according to ALLIC 2009 protocol, and FVIII replacement. On day 33 of treatment, the patient achieved complete remission. He finished successfully the first 6 months of treatment and he will hopefully continue on maintenance phase of the protocol.
Conclusion
The most common haemorrhagic disorder in children with leukaemia is disseminated intravascular coagulation (DIC). The diagnosis of haemophilia A is very rare and there is no clear therapeutic plan in such cases, but timely diagnosis should not be delayed and proper treatment should be based on clinical findings.
Keyword(s): Acute lymphoblastic leukemia, Hemophilia A, Pediatric