Fulminant congenital leukemia presenting with coma and intracranial hemorrhage: the first case report from Kazakhstan
6 affiliations
- 1Department of Pediatrics named after Associate Professor D.M. Tussupova, Semey Medical University, Semey, Kazakhstan
- 2Department of General Practice, Semey Medical University, Ust-Kamenogorsk, Kazakhstan
- 3Department of Medical Rehabilitation and Neonatology, Semey Medical University, Semey, Kazakhstan
- 4Department of Microbiology and Virology named after Sh. I. Sarbasova, Astana Medical University, Astana, Kazakhstan
- 5ReSTORE Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 6Central Research Facility, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, India
Abstract
Background and aimCongenital leukemia is an extremely rare condition, with an estimated incidence of 1–5 per 1,000,000 live births, characterized by an aggressive clinical course and poor prognosis.Case presentationWe report a case of congenital leukemia in a 1-month-old male infant with an unremarkable family and antenatal history, admitted to the intensive care unit in a comatose state (Glasgow Coma Scale score of 3) with suspected intracranial hemorrhage. Laboratory evaluation revealed a WBC count of 1,000 × 109/L with 99% blast cells. The clinical course was complicated by severe hemorrhagic manifestations, including multiple intracerebral hemorrhages and cerebral edema. Despite multidisciplinary supportive management involving pediatricians, neonatologists, neurologists, and neurosurgeons, cytoreductive procedures such as leukapheresis or exchange transfusion could not be undertaken because of hemodynamic instability, active intracranial bleeding, and resource limitations, and the patient died within 24 h of admission. The diagnosis of acute myeloid leukemia with a KMT2A (MLL) rearrangement was confirmed postmortem.ConclusionsOur case demonstrates the aggressive nature of congenital leukemia and its potential to present with life-threatening hemorrhagic complications. Early recognition and rapid diagnostic evaluation are essential; however, prognosis remains poor in fulminant cases. Multidisciplinary management is critical for timely decision-making and supportive care. This report emphasizes the importance of considering congenital leukemia in neonates presenting with unexplained coma and hyperleukocytosis, even in the absence of typical clinical signs.
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BibTeX
@article{tugelbayeva2026fulminant,
title = {{Fulminant congenital leukemia presenting with coma and intracranial hemorrhage: the first case report from Kazakhstan}},
author = {Aigul Tugelbayeva and Aizhan Abylgazinova and Nazym Ailbayeva and Aizhan Mukazhanova and Aigul Utegenova and Vijay Kumar Chattu and Vijay Kumar Chattu},
journal = {Frontiers in Pediatrics},
year = {2026},
month = nov,
doi = {10.3389/fped.2026.1871538},
url = {https://doi.org/10.3389/fped.2026.1871538},
note = {CC BY},
}
RIS
TY - JOUR
TI - Fulminant congenital leukemia presenting with coma and intracranial hemorrhage: the first case report from Kazakhstan
AU - Aigul Tugelbayeva
AU - Aizhan Abylgazinova
AU - Nazym Ailbayeva
AU - Aizhan Mukazhanova
AU - Aigul Utegenova
AU - Vijay Kumar Chattu
AU - Vijay Kumar Chattu
PY - 2026
DA - 2026/11/03
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.1871538
UR - https://doi.org/10.3389/fped.2026.1871538
AB - Background and aimCongenital leukemia is an extremely rare condition, with an estimated incidence of 1–5 per 1,000,000 live births, characterized by an aggressive clinical course and poor prognosis.Case presentationWe report a case of congenital leukemia in a 1-month-old male infant with an unremarkable family and antenatal history, admitted to the intensive care unit in a comatose state (Glasgow Coma Scale score of 3) with suspected intracranial hemorrhage. Laboratory evaluation revealed a WBC count of 1,000 × 109/L with 99% blast cells. The clinical course was complicated by severe hemorrhagic manifestations, including multiple intracerebral hemorrhages and cerebral edema. Despite multidisciplinary supportive management involving pediatricians, neonatologists, neurologists, and neurosurgeons, cytoreductive procedures such as leukapheresis or exchange transfusion could not be undertaken because of hemodynamic instability, active intracranial bleeding, and resource limitations, and the patient died within 24 h of admission. The diagnosis of acute myeloid leukemia with a KMT2A (MLL) rearrangement was confirmed postmortem.ConclusionsOur case demonstrates the aggressive nature of congenital leukemia and its potential to present with life-threatening hemorrhagic complications. Early recognition and rapid diagnostic evaluation are essential; however, prognosis remains poor in fulminant cases. Multidisciplinary management is critical for timely decision-making and supportive care. This report emphasizes the importance of considering congenital leukemia in neonates presenting with unexplained coma and hyperleukocytosis, even in the absence of typical clinical signs.
SN - 2296-2360
ER -