Infant acute lymphoblastic leukemia (MLL-AF) presenting as leukemia cutis with an isolated scalp nodule – A case report

Background Infant leukemia is a rare form of acute leukemia diagnosed prior to 1 year of age with an extremely poor prognosis, due to its poor response to current therapies. It comprises about 4% of childhood acute lymphoblastic leukemia (ALL). Isolated initial cutaneous involvement in ALL is very uncommon, and even more in infant ALL. Case Presentation Here we present a case of 2-month-old infant, presenting only nodular skin infiltrates on the scalp with the diagnosis of infant acute lymphoblastic leukemia (ALL), characterized by the immunophenotype of the most immature B-cell precursors (pro-B ALL) and chromosomal translocation t (9;11), associated with the rearrangement of KMTLA2 and AF9 genes, that is a negative prognostic factor. She underwent hematopoietic stem cell transplantation (HSCT) and she is still in remission Conclusions This represents a peculiar case because isolated initial cutaneous involvement in ALL is rare. In fact, most reports of ALL leukemia cutis in literature are single cases. The novel treatment strategies, obtained from recent discoveries regarding the peculiar biology of these leukemias, are increasingly being incorporated into clinical trials and have the potential to improve the prognosis.