Neonatal Leukaemia: Everything You Need To Know About This Cancer

In almost two-thirds of patients, this disease can manifest in the form of acute myeloid leukaemia (AML) and remains a major life-threatening malignancy in children.

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Childhood leukaemia or neonatal leukaemia is a type of cancer that is most common in newborns and teens. It occurs after abnormal white blood cells form in the bone marrow and quickly travel through the bloodstream and crowd the healthy cells.

This reduces the body's immunity significantly and makes it prone to infection and other problems. 

It generally shows up within the first 28 days of life and in most cases, it is congenital.

In fact, in almost two-thirds of patients, this disease can manifest in the form of acute myeloid leukaemia (AML). That's why, neonatal leukaemia remains a major life-threatening malignancy in children, and unfortunately, the current survival rate is 10 per cent in babies, when compared to 70 per cent in teens.

As tough as it is for a child to have cancer, most children and teens with childhood or neonatal leukemia can be successfully treated. Let's take a deeper look into this disease and how it can be spotted through specific symptoms. 

What Is Neonatal Leukemia?

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Neonatal leukaemia is present in infants at birth or can develop within the first month of their life. In almost 75 per cent of the infant leukaemia cases, there is an abnormality of the gene MLL, on chromosome band 11q23. All the necessary mutations occur in the utero.

Causes Of Neonatal Leukemia

Researchers found that maternal exposure to DNA topo 2 inhibitors during pregnancy can be linked to the development of congenital leukaemia. So, the foetus is basically gets exposed to DNA topo 2 inhibitors through maternal diet and medications. 

Hence, it is very important to take care of your diet when you are pregnant.

DNA topo 2 inhibitors can be found in not only some specific fruits and vegetables, but you can also find them in soy, coffee, wine and cocoa, along with few medicines. 

There is, in fact, a ten-fold higher risk of infant AML with the increase in maternal consumption of DNA topo 2 inhibitor-containing foods.

Advanced maternal age is also a major risk factor for neonatal leukaemia. Parental age has been linked with several childhood cancers but there has been no strong evidence to back the studies. 

Major Symptoms Of Neonatal Leukemia

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It can be quite traumatic to see your infant go through the pain, but here are some common symptoms of AML. 

1. Rashes

When the cancer cells of AML spread from the blood and bone marrow to the skin, you can spot rashes on your infant's body. They can look like lumps and spots that may resemble ordinary rashes.

On light skin tone, these rashes may often appear as red or purple in colour. On the other hand, if the complexion is dark, the rash may look darker and will be less noticeable.

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2. Bruises

There can also be bruises on your infant's body. This mainly happens due to the low platelet count. Platelets usually do the work of stopping the bleeding including under the skin. Having fewer platelets means that bruises appear more easily and show up clearly.

3. Swollen gums

Your infant may also suffer from swollen gums. You may find that bleeding happens more than usual because of the inflammation in the mouth. As AML causes a reduction in red blood cells, some of the other symptoms that you can notice are fatigue, dizziness, headaches, and pale skin.

Diagnosis Of Neonatal Leukemia

The doctors need to rule out any congenital infections before the diagnosis. 

Here are some tests that they can do to detect the stage of leukaemia:

After the physical test, where the doctor will try to look for swollen glands, anaemia and other symptoms, a blood test would be recommended. 

  • Blood test: It is more accurate than a physical examination. This will help the doctor to determine any abnormal growth of WBCs indicating leukaemia.  
  • Bone marrow test: In this test, the doctors take a sample of the bone marrow from the hip using a long needle.

Treatment Of Neonatal Leukemia 

The treatment for neonatal leukaemia includes intensive multi-agent chemotherapy. Your infant will need age-related dose adjustments along with supportive care. 

Stem cell transplant is another possible treatment. This is also a common procedure to cure cancer. In this treatment, doctors replace the diseased bone marrow with a healthy one. 

Neonatal leukemia is a rare disorder with a bleak prognosis but there is still some hope. Any hematologic abnormalities that can arise due to complications from chemotherapy can increase the risk of a haemorrhage. So surgical intervention can be recommended in this case.

However, surgeons will need to exercise extreme caution when considering craniotomy (a surgical operation, where the bone flap is temporarily removed from the skull to reach the brain).

When leukaemia may be present later in infancy, the signs and symptoms are often less specific and they can include low-grade fever, lethargy, bleeding diathesis, diarrhoea, or failure to thrive. 

Chemotherapy can help cure neonatal leukemia. But there is a high risk of relapse and treatment in infants and toddlers when compared to older children.

However, don't let it dishearten you. There are advancements happening every year and there is a sliver of hope for young toddlers suffering from this disease.  

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Source: NCBI, Medical News Today

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Written by

Sarmistha Neogy