A case of infantile acute monocytic leukemia caused by vertical transmission of the mother's leukemic cells

Article Abstract:

Approximately 300 pregnancies complicated by leukemia have been reported in the medical literature. In two cases, the leukemia occurred simultaneously in both mother and infant. However, in neither report was the source of the infant's leukemic cells established. Now a case has been observed in which the infant's leukemia was established to be his mother's. A 32-year-old woman was diagnosed as having acute monocytic leukemia after the birth of her third child. The baby boy was healthy until 20 months of age, when he developed fever; the diagnosis of acute monocytic leukemia soon followed. The examination of the baby's leukemia cells revealed that they were immunologically identical to the mother's on the basis of immunofluorescent staining, HLA typing, and mixed lymphocyte culture. Karyotyping, or examination of the chromosomes, revealed that many of the infant's bone marrow cells had female chromosomes, confirming the cells came from the mother. Curiously, although the mother's leukemic cells showed chromosome abnormalities, the female leukemic cells inherited by the child did not. The child was treated with chemotherapy and a bone marrow transplant from his HLA-identical brother. The mother was treated with chemotherapy. Both are alive and in remission for over three years. The case raises two questions. It is unclear why the leukemia developed over a 20-month period in the child, and why the immune system of the infant failed to destroy the foreign cells. (Consumer Summary produced by Reliance Medical Information, Inc.)

Disease transmission, Acute leukemia

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Neurofibromatosis and acute monocytic leukemia in adults

Article Abstract:

Neurofibromatosis (NF), or von Recklinghausen's disease, has been popularized as the "elephant man" syndrome in its more severe manifestations. It is the most common genetic disorder which has a dominant, rather than a recessive, mode of Mendelian inheritance. A number of tumors have been reported to be associated with NF at a rate greater than that due to chance. Among them is chronic myelogenous leukemia, which may be associated with NF in childhood. The association of leukemia with NF is uncommon in adults, however. In the case of a 60-year-old man with fever and excessive white cell count, examination revealed evidence of cancerous bone marrow. Multiple neurofibromas covered the abdomen and face. Further examination led to a diagnosis of acute monocytic leukemia. The patient experienced a short remission under chemotherapy, but then relapsed and died. The precise mechanism leading to the development of neurofibromatosis is not known. It is possible that the underlying genetic defect may render other cell types more susceptible to transformation into cancer cells. However, it is worth noting that the embryonic heritage of the neurofibromas is very different from the monocytic leukemias, and that the cancer-causing effects may well be indirect. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Somatostatin-producing duodenal carcinoids in patients with von Recklinghausen's neurofibromatosis: a predilection for black patients

Article Abstract:

A review of 116 cases of duodenal carcinoids revealed that eight patients also suffered from von Recklinghausen's disease (VRD). Seven of the eight patients were black. Of the patients with duodenal carcinoids without von Recklinghausen's, only 22 percent were black, suggesting that there may be a predilection for duodenal carcinoids among blacks with von Recklinghausen's disease. Although the association of VRD with duodenal carcinoids has been previously reported, there has been no mention of race factors, and some reports do not specify the race of their patients. In any patient with VRD, gastrointestinal symptoms or jaundice should alert the clinician to the possibility of duodenal carcinoids, especially if the patient is black. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Risk factors, Physiological aspects, Race, Blacks, Carcinoid, Carcinoid tumor

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