Rare Association of Myeloid leukaemia of Down Syndrome with Granulocytic Sarcoma.

We report an 18-months old boy with trisomy 21 who initially presented with myelodysplastic syndrome MDS, and later transformed into acute megakaryoblastic leukaemia AML. At presentation he was found to have some unusual findings namely multiple soft tissue masses over scalp, left elbow and over the knee joints as well as hard mass felt in left hip. Biopsy of soft tissue of scalp revealed granulocytic sarcoma. Generally granulocytic sarcoma is seen with AML-M2 and its association with AML-M7, to our belief has rarely been reported previously.

Avascular necrosis of bone in children with leukemia: experience of pediatric hematology unit in kuwait.

Avascular necrosis of the bone (AVNB) is an uncommon serious complication of acute leukemia. Between the years 1997-2007, seven children with acute leukemia of different risk groups presented with symptoms, signs and investigational evidence of avascular necrosis of bone. They were all diagnosed during their maintenance chemotherapy except one patient who had AVNB post-transplant following hematological relapse. Six patients had avascular necrosis of the hip (AVNH), and one patient had avascular necrosis of the foot. Other complications for steroids, such as hyperglycemia were observed in some of the patients. The steroids were omitted in almost all patients immediately. Two patients had surgical intervention and the rest received conservative management. Two patients recovered fully and the rest are still under follow-up at orthopedic clinic pending further management.