DefinitionACUTE LYMPHOCYTIC LEUKEMIA (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.SymptomsTop of Form§ Bleeding from the gums§ Fever§ Frequent infections§ Frequent or severe nosebleeds§ Lumps caused by swollen lymph nodes in and around the neck, underarm, stomach or groin§ Pale skin§ Shortness of breath§ Weakness, fatigue or a general decrease in energy CausesTop of Bottom of FormACUTE LYMPHOCYTIC LEUKEMIA occurs when a bone marrow cell develops errors in its DNA. The errors tell the cell to continue growing and dividing,Risk factorsTop of Form§ Previous cancer treatment..§ Exposure to radiation..§ Genetic disorders.. § Having a brother or sister with ALL..Tests and diagnosisCLICK TO ENLARGE§ Blood tests..    Bone marrow test..§ Imaging tests..      Spinal fluid test..Treatments and drugsTop of Form§ Induction therapy..      Consolidation therapy..§ Maintenance therapy..§ Preventive treatment to the spinal cord..§ Chemotherapy..      Targeted drug therapy..§ Radiation therapy..     Stem cell transplant..§ Clinical trials..Alternative medicineTop of Form§ Acupuncture     Aromatherapy    Massage§ Meditation     Relaxation exercisesCoping and supportTop of Form§ Learn enough about LEUKEMIA to feel comfortable making treatment decisions.§ Lean on your whole health care team..§ Explore programs for children with cancer..§ Help family and friends understand your situation.

Background and aims: ACUTE LYMPHOCYTIC LEUKEMIA (ALL) is an aggressive neoplasm and appearing of that with severe eosinophilia is a rare coincidence. In this study a case of severe LEUKEMIA with aggressive appearance of eosinophilia is reported.Case report: In this report an 18-years old boy with severe eosinophilia is presented. An 18- years old boy with fatigue, low fever, tachy cardia, periodic weakness and diffuse erythroderma is presented. On physical examination, splenomegaly was seen in his visit sessions. Total leucocytes were 50000 cu/mm with 60% eosinophil in his complete blood. The level of Hemoglobin and hemotoblast was normal. His bone marrow examination showed a hyperplasic marrow incretion with increase in eosinophilia and lymphoblast. The bone marrow examination and blood samples experiment of flow cytometry showed pre B cell ALL with eosinophilia.Patient was treated with hyper CVAD, but it didn’t work. Then he was treated with FLANG diet which results in complete remission achievement. Finally, patient was gone under allogenic bone marrow transplantation.Conclusion: Therefore, it is suggested to concern about ALL in patients with increasing Eosinophilia, and prerequisites treatment should be done.

Introduction: Campylobacter jejuni is a slender, motile, non-spore-forming, helical-shaped, gram-negative bacterium. It isoneof the most common causes of human gastroenteritis in the world. The aim of this study was to present a patient with ACUTE LYMPHOCYTIC LEUKEMIA (ALL), who was infected with Campylobacter jejuni.Case Presentation: We describe the medical records of a pediatric ALL patient with bacteremia caused by C. jejuni, who was diagnosed at Amir hospital, Shiraz, Iran. This 14-year-old male visited the emergency department of Amir hospital with night sweats, severe polar high-grade fever, reduced appetite, and nausea in August 2013. Given the suspected presence of an anaerobic or microaerophilic microorganism, aerobic and anaerobic blood cultures were performed using an automated blood cultivator, the BACTEC 9240 system. In order to characterize the isolate, diagnostic biochemical tests were used. Antibiotic susceptibility testing was done with the disk diffusion method. The primary culture was found to be positive for Campylobacter, and the subculture of the solid plate yielded a confluent growth of colonies typical for Campylobacter, which was identified as C. jejuni by morphological and biochemical tests. The isolate was resistant to ciprofloxacin, cefotaxime, cephalexin, piperacillin/tazobactam, nalidixic acid, aztreonam, cefuroxime, cefixime, ceftazidime, and tobramycin.Conclusions: C. jejuni should be considered in the differential diagnosis as a potential cause of bacteremia in immunosuppressed patients. In cases where the BACTEC result is positive in aerobic conditions but the organism cannot be isolated, an anaerobic culture medium is suggested, especially in immunocompromised patients.

Background: With advent of modern chemotherapy regimens ACUTE LYMPHOCYTIC LEUKEMIA (ALL) has gained a much better prognosis in adults. Hyper-CVAD is an effective regimen with over a decade of experience but studies on outcomes in different populations are scarce.Methods: All adult ALL patients who were admitted for the first time to the Hematology and Oncology ward of Imam Khomeini Hospital, between October 2007 and February 2009 were recruited. The patients underwent hyper-CVAD regimen and short-term outcomes were measured.Results: Thirteen male and ten female patients with a median age of 27 y were recruited. Flocytometry showed 14 (61%) pre-B, 3 (13%)T, 5 (22) B and 1 (4%) unknown of subtypes of LYMPHOCYTIC LEUKEMIA. Cytogenetic abnormalities were identified in 4 patients which were t (9;22), Klinefelter 47 (xxy)+trisomy 5, hyperdiploidy and tetraploidy. In response to our induction 18 (78%) went into complete remission (CR) and 3 patients (13%) became refractory. We also had 2 (9%) mortality of induction phase. Fever and neutropenia as our complications were seen in 12 (52.2%) patients. 9 (39.1%) patients was our mortality rate (2 during induction, 2 in consolidation, 4 after relapse with salvage and 1 with salvage being refractory).Discussion: Short-Term outcome of hyper-CVAD regimen shows a poorer prognosis compared with other reported data probably attributed to a different genetic background and clinical settings which warrants further long-time investigations in our population.

Methotrexate (MTX) is a folic acid antagonist and is one of the most commonly utilized chemotherapeutics in cancer treatment. 1 MTXrelated neurotoxicity occurs in only 3. 1%-3. 8% of cases and manifests with ACUTEly and clinically alarming symptoms. 2 These symptoms can be mistaken for other etiologies such as stroke, seizure, headache, and disorientation. 2-5 Due to the ambiguous presentation, differentiation and diagnosis are extremely critical yet incredibly challenging in an emergency department (ED) setting. This case will discuss the treatment and outcomes of a patient who was diagnosed with leukoencephalopathy due to MTX toxicity.

Background: MLL-AF4 positive LEUKEMIAs comprise about 50-70% of ACUTE lymphoid LEUKEMIAs in children and about 5% of adolescents and adults Despite recent advances in the treatment of hematologic malignancies of children with ALL in particular, but it seems that poor results are obtained from treating this type of malignancy. Perhaps it is due to the lack of enough knowledge about the expression pattern of the fusion gene induced by chromosomal translocations. This study aims to consider several aspects of the common chromosomal disorder, t (4; 11): due to lack of accurate statistical results for this type of translocation in our country, acceptable results are provided; Sprevalence of isoforms of recombinant genes involved in MLL-AF4 are explained.Materials and methods: Of 36 patients with ALL between 4 months -11 years of age, peripheral blood sampling was done and total RNA extracted and cDNA was made. Then cDNA was amplified in two steps with the PCR and Nested PCR reactions. After electrophoresis the products were compared and analyzed in comparison with the internal control.Results: The results showed that MLL-AF4 recombinant gene expression in the age between 4 to 12 months range is maximum in the second stage by Nested PCR. Also the highest frequency of fusion isoforms of the gene involved in the same age range is e11-e4 isoform with the frequency of 0.13.Conclusion: It seems that investigation of translocation and chromosomal abnormalities using molecular techniques is one of the most accurate and suitable methods for identifying chromosomal characteristics in patients with ACUTE LEUKEMIA, particularly ALL.

Background: ACUTE LYMPHOCYTIC LEUKEMIA (ALL) is a cancer of the lymphoid line of blood cells. It is characterized by the development of large numbers of immature lymphocytes. It is one of the most common cancers among children. Molecular markers can play an important role in determining the nature of LEUKEMIA-related tumors and can be used as a diagnostic adjuvant along with precise pathological methods. Some research has shown that apolipoprotein A1 gene polymorphisms were associated with the formation of various types of diseases. Objectives: This study aimed to evaluate the association of ApoA1 gene insertion/deletion polymorphisms with ALL disease. Methods: The salting-out method was used for DNA extraction from the blood samples. Questionnaires were prepared with the approval of a demographic data expert. The genotype distribution and allele frequencies for the ApoA1 gene insertion/deletion polymorphisms were determined by Gap-polymerase chain reaction (Gap-PCR) to compare patient’ s cases with ALL disease and healthy subjects. This case-control study was performed by odds ratio (OR, with a confidence interval of 0. 95) to reveal the association of these polymorphisms with ALL disease. Results: In this study, two ApoA1 gene polymorphisms, including II and DD genotypes, were observed, which II genotype had the highest frequency in both groups of healthy subjects and patients. However, no significant differences were found between the two groups (P > 0. 05). ALL and both genotypes had a higher frequency in males than females. Despite the high frequency of both genotypes in males, there were no significant differences between healthy subjects and patients in terms of age and sex (P > 0. 05). Conclusions: Based on the results of this study, it can be concluded that ApoA1 gene polymorphisms were not associated with ALL disease. It was not effective in the formation or exacerbation of it in this population. Also, it could not be identified as a prognostic marker. It should be noted that these findings are the first report of the degree of association of ApoA1 polymorphisms with ALL.