Case Report
A 5.5-month-old girl admitted to our hospital with swelling on the
cheek. Her physical examination revealed that she had ectrodactyly on
right hand (Figure 1). She was tachypneic. She had splenomegaly (2 cm
bellow coastal margin) and umbilical hernia with abdominal distention.
Routine blood test results revealed anemic hemoglobin level of 5.9 g/dl,
increased leukocyte count 26 570 /mm3 and platelet count of 104 000/mm3
with peripheral blasts. In addition LDH level increaesed to 1126 U/L,
liver function and renal funtion tests were in normal range.
Echocardiographic and chest radiography findings were normal. Right
forearm radiography showed 2-4th phalangial bone aplasia (Figure 1).
Abdominal sonography revealed two fold enlarged kidney. Bone marrow
examination revealed 52 % L1 type lymphoblasts, which had high
positivity for CD 19, CD22, CD38, cyM, cy TDT, cy 79a ve HLA DR. Only
12% of blasts were dim and other blasts were negative for CD10. She
hadn’t central nervous system infiltration. Chemotherapy was started
according to BFM İnterfant -2006. She had a good prednisolon response
and minimal residual disease at day 15 of induction therapy showed low
risk. Bone marrow aspiration at the end of the induction therapy
complete remission was achieved with no blast. At the same time her
kidney dimensions at sonography revert to normal. She has continued to
consolidiation therapy according to the BFM interfant 2006 protocol.