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This article reports peripheral blood film and cytogenetic results of a five day old neonate who presented with history of high grade fever, vomiting and jaundice. Peripheral blood film showed presence of 30% blast cells which were large in size having abundant granular cytoplasm. Karyotyping results revealed presence of trisomy 21. She was diagnosed as a case of Down syndrome with congenital leukemia. Approximately 10% of such cases present as Transient Abnormal Myelopoiesis. Persistence of blast cells beyond six months is an indication for treatment...
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