Philadelphia Chromosome Positive B-lymphoblastic Leukemia in an Infant

Abstract

Acute Lymphoblastic Leukemia (ALL) in infancy is a rare entity with reported incidence of 2.5-5% of total childhood ALL.1 It usually presents with organomegaly, hyperleukocytosis, central nervous system (CNS) involvement and B-cell phenotype. Acquired mixed lineage leukemia (MLL) gene rearrangement on chromosome 11q23 is the most observed cytogenetic abnormality in infantile ALL with an incidence of ~80%.2 The Philadelphia (Ph) chromosome positive B-lymphoblastic leukemia (B-ALL) is uncommon in childhood (<5%) and exceptionally rare in infants.3 Here, we report a case of infantile B-ALL with presence of Ph chromosome and absence of MLL gene rearrangement.An 11-month infant boy presented with complains of fever and irritability. On examination, he had cervical lymphadenopathy, and hepato-splenomegaly. Complete blood count (CBC) showed haemoglobin (Hb) 8.7gm/dl, total leucocyte count