1. A neonate with Down syndrome is found to have hepatosplenomegaly and a violaceous skin infiltrate. Her FBC shows WBC 27.2 _109 /l, Hb 139 g/l and platelet count 27 _109 /l. A blood film shows blast cells, some of which have basophilic cytoplasm and cytoplasmic blebs, and are thought likely to be megakaryoblasts. There are occasional micromegakaryocytes, nucleated red cells and granulocyte precursors. It is concluded that the skin lesion is leukaemia cutis. The most appropriate management is: a Corticosteroids b Cytarabine and daunorubicin c Observation d Platelet transfusion e Red cell and platelet transfusion
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