ACUTE MYELOGENOUS LEUKEMIA (AML) is a hematological malignancy, which accounts for about 15-25% of childhood's LEUKEMIA. Genetic factor is one of the most important predisposing elements in childhood ACUTE LEUKEMIA, especially AML. In this case report, a rare presentation of familial AML is presented in three monozygotic triplets. Two were 10 months old, and the other one was 16 months old at presentation. Chemotherapeutic regimen was administered for all three sisters with good response and success in maintaining remission.

Purpose: To report a case of ACUTE MYELOGENOUS LEUKEMIA (AML) presenting with periorbital cellulitis and progressing to facial and neck cellulitis. Case Report: A 17 year old male patient presented with periorbital cellulitis which progressed to the right hemifacial and neck area. He did not respond to regular antibiotic therapy. Peripheral blood smear showed leukocytosis with predominance of immature cells, thrombocytopenia and anemia. Bone marrow biopsy confirmed a diagnosis of ACUTE MYELOGENOUS LEUKEMIA.Conclusion: ACUTE LEUKEMIA must be considered in the differential diagnosis of periorbital cellulitis.

The hematological malignancies associated with nephrotic syndrome are mainly hodgkin’s and non-hodgkin’s lymphomas and chronic lymphocytic LEUKEMIA. ACUTE MYELOGENOUS LEUKEMIA (AML) has rarely been described in associated with nephritic syndrome.We report a rare case of ACUTE MYELOGENOUS LEUKEMIA who presented with nephrotic syndrome. A previously healthy 62-year-old man was admitted in nephrology ward because of generalized developing pitting edema during last month. Simultaneously, he had generalized itching and urticaria, polyuria, polydypsia and low grade fever but had no history of weight loss, anorexia and sweating. In laboratory tests he had proteinuria above 3.5 gr/ day. Because of anemia, hematology consultation was done. In peripheral blood, there were myeloblast cells in the circulation at a ratio of 20%. Bone marrow aspiration confirmed a diagnosis of AML M2, showing hypercellular bone marrow with 80-90% leukemic cells, increased M/E ratio, myeloblast (immature cell, fine chromatin, cytoplasmic granule) and these abnormal elements: myeloblast>50% and mature cell about 20%. Unfortunately, we hadn’t renal biopsy as a consequent of patient illness and thrombocytopenia. He received induction chemotherapy, which led to a complete remission and decreasing urinary protein excretion during chemotherapy and no proteinurai at the end of it. Now the patient has received second course of consolidation therapy and remained in complete remission, with no physical and laboratory evidence of proteinuria. It can be concluded that nephrotic syndrome may be additionally associated with AML. In some cases, there is a direct causal effect of the leukemic process on renal function or even pathology, while in others it is exerted indirectly via other complications of the malignancy or the treatment.

Sjogren’s syndrome (SS) is a systemic autoimmune disease that presents with sicca symptoms of the main mucosal surfaces. The spectrum of disease extends from sicca syndrome to systemic involvement and may be complicated by the development of lymphoma.Many types of malignant and pseudo malignant diseases have been reported, but the most important is non Hodgkin lymphoma.We here present a 45 year-old woman with SS that referred with pancytopenia. By molecular and histochemical techniques a diagnosis of ACUTE myeloblastic LEUKEMIA of M3 type (AML-M3) was made for this patient.

A retrospective study was done on 130 AML patients treated in Shariati and Imam Hospitals in Tehran from 1991 to 1997 to investigate the value of three post-remission methods of treatment. All patients who were in complete remission (CR) (Group I) had been treated with ARA-C (300 mg/m2/day continuous infusion for 5 days) and Daunorubicine (45 mg/m2/day for 3 days) as induction and early consolidation therapy. Forty patients were treated by-additional similar chemotherapy as second consolidation and no further treatment was offered. Fifty patients (Group Il) were treated by ARA-C (120 mg/m2 subcutaneously for 5 days), Etoposide (120 mg/m2 on day one), and Mitoxantrone (12 mg/m2 on day one) on each successive month as short-term miniconsolidation. Forty patients (Group Ill) were treated similarly to Group Il until relapse for up to two years as long-term miniconsolidation. There was no difference in the three groups regarding mean age and other prognostic factors. Treatment related mortality and morbidity were also similar.Median duration of disease-free survival (DFS) was 36 (3.5-68 with 95% Cl), 17 (12.5-21.5) and 19 (14.7-23.3) months respectively in these three groups. In a 14- month median observation there was no difference in DFS and overall survival (OS) among the three groups (p=0.7). We concluded that short- or long-term miniconsolidation chemotherapy compared to standard treatment does not improve DFS and OS in AML patients.