1Clinical Chemistry Laboratory, ASST PAPA Giovanni XXIII Bergamo, Bergamo, Italy.
2Hematology Unit, ASST PAPA Giovanni XXIII Bergamo, Bergamo, Italy.
A small-for-gestational age male infant was born at 32 weeks of gestation, with Down syndrome, congenital heart disease, and hydrops. The total blood cell count results revealed 172.6×109/L leukocytes, anemia (hemoglobin of 97 g/L), and normal platelet count. The microscopic review of peripheral blood showed extremely high leukocyte count and most of the cells were blasts (90.5%). In particular, nucleated red blood cells, with abnormal platelet size and content, were found: (