i have a PT 26 weeker with pancytopenia noted on the 1st CBC ( WBC 0.7 neutriophil o.o2, plt 70S , infections rolled out , and metabolic workup for inborn error of metabolism were negative, chromosome normal , bone marrow showed AML , baby currently 30 days old , clinically stable . on full feed hemaologist considering starting chemo at anytime point.I wanted your opinion and experience (references if possible).

i would appreciate your input.

Dr J Alallah

consultant neonatologist

I have only one experience from cytostatic medications to newborns, an ELBW infant who developed histiocytosis while being in the NICU.

This infant was treated with etoposide, dexamethasone, and immunoglobulin.

The case was reported in Acta Paediatrica, here's the PubMed URL:

http://www.ncbi.nlm.nih.gov/pubmed/17888050

At 30 weeks, not sure chemo is a good idea...in kids with Trisomy 21, disease may totally resolve...why not give it some time?

See:

http://www.cancer.gov/cancertopics/pdq/treatment/childAML/HealthProfessional/page8

I also found a site that did treat a premie successfully...

http://www.ncbi.nlm.nih.gov/pubmed/19779381

Jody Gross

Ministry Children's Hospital

Marshfield, WI, USA