mercaptopurine and Splenic-Diseases

A 3 months old girl presented with significant enlargement of liver, spleen and lymphnodes, with moderate anemia, thrombopenia and leucocytosis. In the differential count there was a shift to the left and an increase of monocyte-like cells (35%). Differential diagnosis included leucemoid reaction, infectious mononucleosis, myelo-proliferative disorder with a missing C chromosome and chronic myeloid leucemia. Clinical symptoms, cytochemistry and caryotype of bone marrow cells suggested infantile chronic myeloic leucemia and normal ALP index and possibly normal HbF. Treatment with 6-mercaptopurine was followed by partial remission. The therapeutic consequences of exact differential diagnosis are discussed.

Topics: Anemia; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Humans; In Vitro Techniques; Infant; Infectious Mononucleosis; Leukemia, Myeloid; Leukocytosis; Liver Diseases; Lymphatic Diseases; Mercaptopurine; Myeloproliferative Disorders; Splenic Diseases; Thrombocytopenia

Topics: Adolescent; Adult; Bone Diseases; Bone Marrow; Bone Marrow Cells; Child; Female; Gallbladder Diseases; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Myocardium; Pancreatic Diseases; Pericardial Effusion; Prednisone; Splenic Diseases; Time Factors; Vincristine