Congenital leukemia: comprehensive nursing care for a rare disease: a case study.

Congenital leukemia is a rare hematological disorder. The initial manifestation of the disease may be the presence of blue or gray skin nodules. The presence of these nodules along with hyperleukocytosis, anemia, hepatosplenomegaly, and central nervous system leukemic involvement are characteristic of the disease. Treatment involves the administration of chemotherapy by protocol. Response to the chemotherapy is generally poor. Infants with Down syndrome may have a transient manifestation of leukemia known as a leukemic disorder; this will resolve without chemotherapy. Other neonatal disorders can also mimic congenital leukemia; the infant must be evaluated for these, in addition to the definitive diagnosis made via bone marrow aspiration and examination. There are many nursing care interventions for the infant with suspected congenital leukemia. The family of an infant with a suspected or diagnosed leukemia requires concrete information and psychosocial support because the prognosis for these infants is grave. We describe the level of care and subsequent outcome for a premature infant who was diagnosed with congenital leukemia and treated with chemotherapy in a Level III nursery.