Maternal alcohol consumption during pregnancy and the risk of childhood acute leukemia:a meta-analysis

Objective： The authors used a meta-analytic technique to quantify the evidence of an association between ma- ternal alcohol consumption during pregnancy and childhood acute leukemia （AL）, which provided a basis for the prevention of childhood AL. Methods： Relevant literatures of maternal alcohol consumption during pregnancy were comprehensively searched and screened. Subgroup meta-analysis was conducted according to the type of leukemia. Results of research data of maternal alcohol consumption during pregnancy were tested for heterogeneity. Combined OR values and 95% CIs were statistically calculated with RevMan 4.2 software; Funnel plots were applied to conduct bias analysis for those included litera- tures. Results： Ten related literatures were included after data screening, 4593 cases in AL group and 6157 cases in control group respectively. According to heterogeneity test result （X2 = 16.26, P 〈 0.05）, the combined OR values and 95% CI were calculated with random effects model, which were 1.02 （0.92-1.14）, Z = 0.41, P = 0.68 〉 0.05, indicating that there was no significant difference between maternal alcohol consumption during pregnancy and the risk of childhood acute leukemia （AL）. Subgroup analysis： for the association between maternal alcohol consumption during pregnancy and childhood acute lympho- blastic leukemia （ALL）, the combined OR value and 95% CI were 0.92 （0.84-1.00）, Z = 1.92, P = 0.05, indicating that there was significant difference between two groups; for the association between maternal alcohol consumption during pregnancy and childhood acute non-lymphoblastic leukemia （ANLL）, the combined OR values and 95% CI were 0.82 （0.61-1.11）, Z = 1.30, P = 0.19 〉 0.05, indicating that there was no significant difference between two groups. Conclusion： Maternal alcohol consumption during pregnancy is a risk factor in childhood ALL, but not in childhood ANLL.

Reliability and validity of the Chinese version of the PedsQL Multidimensional Fatigue Scale in children with acute leukemia

Background:The PedsQL Multidimensional Fatigue Scale(PedsQL^(TM)MFS)is widely used to rate fatigue in children living in English-speaking countries.However,insufficient instruments are available to conduct parallel assessment on fatigue in parents and children in China.In this regard,an appropriate measurement method must be developed.Objectives:This study aims to determine the reliability and validity of the Chinese-language PedsQL^(TM)MFS.Methods:Children with cancer(n=125)and their parents were surveyed in Guangzhou,China.The parents of children aged 2e4 years completed the PedsQL^(TM)MFS proxy reports,whereas the other children and their parents completed the questionnaires by themselves.Results:The PedsQL^(TM)MFS-Chinese version demonstrated satisfactory internal consistency reliability(child self-report Cronbach's a=0.87;parent self-report Cronbach's a=0.93).The factor loadings of the items ranged from 0.78 to 0.87 for general fatigue,0.56e0.78 for sleep/rest fatigue,and 0.62e0.89 for cognitive fatigue.Conclusion:This study proves that the PedsQL^(TM)MFS-Chinese version is an effective tool for screening fatigue in Chinese children with cancer.

Evolution of the Outcomes of Children with Acute Leukemia in Congo

Background: To lower the mori-mortality related to the aggressiveness of acute leukemia’s chemotherapy regimens, we have implemented in 2017 two low toxicity chemotherapy regimens and new supportive care strategies. The aim of the study is to evaluate our new treatments. Materials and Method: A retrospective study was carried out from January 2014 to May 2021 in the hematology department of the teaching hospital in Brazzaville. The study concerned 47 children diagnosed with acute leukemia. Participants were divided into two groups: acute leukemia diagnosed before 2017 (group 1: 23 children) and after 2017 (group 2: 14 children). They were compared using the chi-square. Results: The median age was 10.0 ± 5.01 years. Features and outcomes of group 2 were better. The median duration of symptoms was shorter: 2.45 ± 2.87 months (p = 0.036). The Karnosky score was higher (p = 0.002) and white blood cell count lower (p = 0.331). Both groups started the treatment with a delay of 6 days. The induction treatment was completed in 69.6% before 2017 versus 93.3% after. The rate of relapse was more important for group 1: 85.7% versus 14.3% (p = 0.01). Conclusion: Trainings of professionals have improved the characteristics outcomes of our patients and should be pursued. Considering the high relapse rate, our protocol will need to be intensified.

Role of microRNA dysregulation in childhood acute leukemias:Diagnostics,monitoring and therapeutics:A comprehensive review

MicroRNAs(miRNAs)are short noncoding RNAs that regulate the expression of genes by sequence-specific binding to mRNA to either promote or block its translation;they can also act as tumor suppressors(e.g.,let-7b,miR-29a,miR-99,mir-100,miR-155,and miR-181)and/or oncogenes(e.g.,miR-29a,miR-125b,miR-143-p3,mir-155,miR-181,miR-183,miR-196b,and miR-223)in childhood acute leukemia(AL).Differentially expressed miRNAs are important factors associated with the initiation and progression of AL.As shown in many studies,they can be used as noninvasive diagnostic and prognostic biomarkers,which are useful in monitoring early stages of AL development or during therapy(e.g.,miR-125b,miR-146b,miR-181c,and miR-4786),accurate classification of different cellular or molecular AL subgroups(e.g.,let-7b,miR-98,miR-100,miR-128b,and miR-223),and identification and development of new therapeutic agents(e.g.,mir-10,miR-125b,miR-203,miR-210,miR-335).Specific miRNA patterns have also been described for commonly used AL therapy drugs(e.g.,miR-125b and miR-223 for doxorubicin,miR-335 and miR-1208 for prednisolone,and miR-203 for imatinib),uncovering miRNAs that are associated with treatment response.In the current review,the role of miRNAs in the development,progression,and therapy monitoring of pediatric ALs will be presented and discussed.

Meta-analysis of Cytochrome P4501A1 MspI Gene Polymorphism and Childhood Acute Leukemia

Objective To investigate the relationship between cytochrome P4501A1 （CYPIA1） Msp I gene polymorphism and childhood acute leukemia （AL）. Methods Relevant literature was extensively searched and screened by Pubmed and Wanfang Database, Chinese Science Journal Database and Chinese Journal Net. Various data consolidation, combined OR values and their 95% CI were tested by RevMan 4.2; Funnel plots were used for the bias analysis. Results Six related literatures were found to meet the requirements. According to heterogeneity results, there was no significant difference in homozygous types（P〉0.05）, while there was significant difference in two others types （P all〈0.05）. For wild CYPIAIMspl homozygous for the reference group, Combined OR of heterozygous mutation, homozygous, heterozygous ＋ homozygous mutation in AL and control groups were 1.18, 0.96, and 1.10 respectively. Subgroup analysis： Z values of CYP1A1Mspl homozygous, heterozygous ＋ homozygous in the acute lymphoblastic leukemia （ALL） and the control group were 0.10 and 0.76 respectively, Z values in non-acute lymphoblastic leukemia and control group were 0.74 and 0.75. Conclusion There is no correlation between CYP1A1Mspl gene polymorphism and the susceptibility of childhood AL.

The Significance and Correlation of SODD and Bel-2 Protein Expression in Acute Leukemia of Children

OBJECTIVE To explore the expression of SODD and bcl-2 proteins in bone marrow cells of children with acute leukemia （AL）, and to examine the relationship of their expression with the classification, clinical features, therapeutic effect and prognosis for AL patients.METHODS Using the SABC immunohistochemical staining method, the expression of SODD and bcl-2 proteins in the bone marrow cells of 86 AL cases was determined. Tqe patients were studied based on the following groups： 1） a first-visiting group; 2） a refractory-relapse group （some patients were sensitive, to therapy but then suffered a recurrence）; 3） a complete-remission group （CR）; 4） a high risk （HR） and 5） standard risk （SR） group; 6） a control group of patients with non-hematologica diseases.RESULTS The positive rates of SODD and bcl-2 expression in the firstvisit, refractory-relapse and CR groups were significantly higher （P〈0,05） compared to the control group. There was no significant difference in the expression of SODD or bcl-2 proteins between an acute lymphoblastic leukemia （ALL） group and acute nonlymphoblastic leukemia （ANLL） group （t=1.874, t=1.583, P〉0,05）. The positive rates of SODD and bcl-2 expression in the patients who developed complete remission after chemotherapy were significantly lower （t=2,054, t=2.703, P〈0.05） compared to the first-visit pediatric patients. The expression of the SODD protein in the refractory-relapse group was notably higher compared to the group treated initially （t=-1.081, P〈0.05）. A high expression of the bcl-2 protein was found in both the first-visit and refractory-relapse groups, with no significant difference found between the two groups （t= -1.196, P〉0.05）, whereas the percentage of bcl-2 positive cells in the refractory-relapse group （45%-87%） was significantly higher compared to the first-visit group （5%-62%）. The positive expression of the SODD and bcl-2 proteins in the high-risk （HR） group were both significantly higher than the SR group （t=-3.236, t=-3.555, P〈0.01）. The Pearson rank correlation analysis indicated that there was a positive correlation between SODD and bcl-2 expressions （P〈0.01, r=0.726）. Among the 30 AL patients in the initial treatment group, 13 patients showed negative SODD expression. These children reached a complete remission （CR） rate of 84.6% （11/13）, while in the other 17 cases with positive SODD expression, the CR rate was 64.7% （11/17）. In 8 patients with negative bcl-2 expression, the CR rate amounted to 100% （8/8）, and in 22 cases with positive bcl-2 expression, the CR rate reached 63.6% （14/22）. Statistical analysis showed that the CR rates in patients with negative expression of SODD and bcl-2 were all significantly higher （P〈0.05） compared to the patients with positive expression.CONCLUSION Both SODD and bcl-2 are closely related to the onset, progression, curative effect aqd prognosis of AL in children. The expression of SODD and bcl-2 has a definite synergistic relationship with the onset and development of AL.

Acute Leukemia in Children

Acute leukemia is the most common childhood cancer and accounts for 31% of all cancers in children. There are two main types of acute leukemia. The most common is ALL （acute lymphoblastic leukemia） affecting the lymphoid lineage, and the more rare AML （acute myeloid leukemia） affecting the myeloid linage. The intention of this thesis is to follow the course of treatment from the admission to the hospital until the last check up and also see how a child will react to the treatment and side effects in later life. We studied literature and my own case records from the period when I was treated for ALL. From the literature and my case records, we can see that children tolerate treatment quite well. Due to rapid diagnostics and the possibility to give high doses chemotherapy, the overall prognosis appears to be very good. Today, acute leukemias of paediatric patients have a really favourable prognosis. The overall survival rate for ALL is higher than 80% and for AML 65%. So the results are good, but there is still a long way to go before we can be satisfied. To date we do not have a contingency program for children treated for acute leukemia after 18 years of age （neither in Norway or Slovakia） so perhaps this should be a focus point in the future. It could be extended to follow up patients in adulthood in order to monitor late effects that may occur in later life after many years of treatment.

Acute Leukemia in Niger: Epidemiological, Diagnostic and Therapeutic Aspects

Objective: Improve the care of patients followed for acute leukemia in the Oncohematology department of the National Hospital of Niamey. Methods: This was a prospective study, over a period of 2 years from January 1, 2018 to December 31, 2019, in patients with acute leukemia in the Oncohematology department of the National Hospital of Niamey (HNN), whose diagnosis was made on a blood smear associated with a myelogram and immunophenotyping and who were consenting. Results: We collected 25 cases of acute leukemia confirmed by myelogram and immunophenotyping. The mean age of the patients was 31.32 years, with a predominance of women, a sex ratio of 0.92. Pupils and students were in the majority with 40% and most came from the Niamey region, i.e. 68%. Anemic syndrome was the most common clinical sign in 96%. ALL predominated in 64% of cases. On the blood count, the hyperleukocytosis was more marked in AML (mean white count: 197256.6 elts/mm3) than in ALL (137891.6 elts/mm3), it was the same for thrombocytopenia which is more marked in AML (75588.89/mm3) than in ALL (52156.25/mm3). Therapeutically, 52% of patients received chemotherapy. The mean overall survival was 16.223 ± 3.191 months, including a mean survival for AML of 6.853 ± 1200 months compared to 21.720 ± 5.920 months for ALL. Conclusion: Acute leukemia still remains a major problem in our context, due to the precariousness of limited financial, diagnostic and therapeutic resources. Thus reflecting in our results, the increasing number of cases, the diagnostic delay and the guarded prognosis. This is the reality in several other countries in the sub-region and even in certain developed countries.

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

The acute lymphoblastic leukemia among Afghan children, Indira Gandhi Children’s Hospital

Objective:Almost all leukemia patients died,fortunately now with the advancement of medicine and science and with the advent of treatment Chemotherapy,Radiotherapy,and Surgical treatment 75%of patients with leukemia who need treatment for up to 5 years,live longer than patients with leukemia who do not receive treatment.On the one side,in our country,Afghanistan the number of incidents has increased recently,and on the other side,we do not have data at the national level.Therefore,the child health hospital administration considered the necessary and left me to research this case in the last 6 months of 2018.Methods:This is an observational descriptive study,which observed 10,293 patients that come to the pediatric internal which 300 patients who indicate leukemia,and 200 patients with acute lymphoblastic leukemia(ALL),who were admitted to the oncology service of Andhra Gandhi Child Health Hospital in 2018 the study took place.Results:Based on the age we detect less than one year’s 10(5%)patients,1-10 years old 150(75%)patients,and more than 10 years old 40(20%)patients.Based on sex,boys were 120(60%)patients and girls 80(40%)patients.Based on clinical findings,anemia 155(77.5%)patients,fever 130(65%)patients,bleeding 90(45%)patients,spleen thickness 88(44%)patients,liver thickness 73(36.6%)patients,lymph nodes thickness 70(35.55%)patients,great pains 66(33%)patients and nervous system disorders 38(19%)patients.Conclusion:We can say with great conviction that 200 patients out of 10,293 had acute lymphoblastic leukemia.Further studies with prospective nature are required to confirm this observation.

DNA repair gene XRCC1 polymorphisms and susceptibility to childhood acute lymphoblastic leukemia: a meta-analysis

Objective： To estimate the relationship between genetic polymorphisms of X-ray repair cross- complementing group 1 （XRCC1） and the susceptibility to childhood acute lymphoblastic leukemia （ALL）. Methods： Relevant case-control studies were enrolled in the meta-analysis. We applied Rev Man 4.2 software to pool raw data and test studies＇ heterogeneity and to calculate the incorporated odds ratio （OR） and 95% confidence interval （95% CI）. Results： Our data showed that the OR for the Gln allele of the Arg399Gln polymorphism, compared with the Arg allele, was 1.35 （95% CI, 1.16-1.57; P〈0.0001） for childhood ALL patients. Similarly, the homozygous genotype Gln/Gln and heterozygous genotype Arg/Gln both significantly increased the risk of childhood ALL compared with the wild genotype Arg/Arg （OR =1.58; 95% CI, 1.13-2.21; P=0.008; OR =1.51; 95% CI, 1.21-1.87; P=0.0002）. The dominant model of Arg399Gln was associated with childhood ALL risk （OR =1.54; 95% CI, 1.25-1.89; P〈0.0001）. The ethnic subgroup analysis demonstrated that the Gln allele in all five ethnic groups was prone to be a risk factor for childhood ALL just with different degrees of correlation while Arg194Trp SNP showed a protective or risk factor or irrelevant thing in different races. Conclusions： XRCC1 399 polymorphism may increase the risk of childhood ALL. Different ethnic groups with some gene polymorphism have different disease risks.

T/myeloid mixed-phenotype acute leukemia treated with venetoclax and decitabine:A case report

BACKGROUND Mixed-phenotype acute leukemia(MPAL)is characterized by acute undifferentiated leukemia with blasts co-expressing myeloid and lymphoid antigens.However,consensus regarding the ideal management strategy for MPAL is yet to be established,owing to its rarity.CASE SUMMARY A 55-year-old male was diagnosed with T/myeloid MPAL.Vincristine,prednisolone,daunorubicin,and L-asparaginase were administered as induction chemotherapy.Septic shock occurred 10 days after induction,and bone marrow examination following recovery from sepsis revealed refractory disease.Venetoclax and decitabine were administered as chemotherapy-free induction therapy to reduce the infection risk.There were no serious infections,including febrile neutropenia,at the end of the treatment.After receiving two additional cycles of venetoclax/decitabine,the patient underwent haploidentical peripheral blood stem-cell transplantation and achieved complete response(CR)to treatment.CONCLUSION CR was maintained in a patient with MPAL who underwent haploidentical peripheral blood stem-cell transplantation after additional venetoclax/decitabine cycles.

Laboratory Diagnosis of Acute Leukemia in Kenya: The Gaps and Opportunities

Acute leukemia (AL) is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development. The diagnosis of leukemia and lymphomas, beyond morphology, is limited in low-resource countries including Kenya. Morphological diagnosis includes Cytological and Histological assessment of blood, bone marrow aspirates and tissues on suspected Acute leukemia patients. The World Health Organization (WHO, 2016) international guidelines on Acute leukemia diagnosis recommend that cytogenetic analysis, appropriate molecular genetics, Fluorescent in situ Hybridization (FISH) testing, and flow cytometric immuno-phenotyping should be done in addition to a morphologic assessment of Acute Leukemia. In facilities where resources are relatively available, immunophenotypic and genetic features have resulted not only in providing a more accurate leukemia diagnosis but also in identifying antigens or genes that can then be targeted for therapy. This article will look at the gaps in the diagnosis of Acute leukemia in low-resource settings like Kenya and opportunities available to improve diagnosis.

Study on the Clinical Efficacy of Megestrol Acetate Dispersible Tablets in Adjuvant Treatment of Acute Leukemia

Objective:To analyze the clinical efficacy of megestrol acetate dispersible tablets in the adjuvant treatment of acute leukemia.Methods:80 patients with acute leukemia admitted from December 2021 to December 2022 were randomly divided into two groups.The control group underwent chemotherapy,and the observation group took megestrol acetate dispersible tablets and underwent chemotherapy.The effect of the treatments were evaluated by analyzing the albumin(Alb)and prealbumin(Palb)indicators,and the adverse reactions were observed.Results:There was no significant difference in Alb and Palb indexes between the two groups before treatment(P>0.05).After treatment,Alb and Palb indexes in the observation group were greater than those in the control group(P<0.05).The incidence of adverse reactions in the control group was 20.00%,which was significantly higher than the observation group(5.00%),with P<0.05.Conclusion:The combination of megestrol acetate dispersible tablets and chemotherapy is more effective in treating patients with acute leukemia,and the Alb and Palb indexes can be optimized.Besides,there are fewer adverse reactions,which means that the treatment is relatively safe.

Management of Severely Malnourished Children Aged 6 - 59 Months Hospitalized in the Pediatric Ward of Kayanza Hospital/Burundi

The implementation of WHO guidelines has significantly reduced hospital mortality due to severe malnutrition. Nevertheless, severe acute malnutrition in children under five remains a major public health problem in all low-income countries and is little studied. The study aimed to assess the nutritional status and quality of management of severe acute malnutrition in children aged 06 to 59 months hospitalized in the pediatric ward of Kayanza Hospital. This is a prospective study with descriptive and analytical aims over 6 months from February 10 to July 9, 2023. All children aged 6 to 59 months admitted for severe acute malnutrition are included in this study. The results show that the most affected age group is 12 to 23 months (42.55%). Marasmus is the most common clinical form, at 70.2%. Housewives and mothers from rural areas are the most affected, with rates ranging from 69.14% to 91.49%. The study shows that the reasons for consultation are respectively: edema (29.78%), diarrhea (26.59%), vomiting (19.14%), and fever (14.89%). Dehydration and hypothermia were the main complications observed in 45.74% and 22.34% respectively. Medical treatment was provided by antibiotics (44.68%), artesunate (31.91%), and resomal (21.27%). Nutritional treatment consisted of F75 100% milk and F100 100% milk. Pathologies observed were: anemia 38.29%, malaria 37.23%, urinary tract infection 12.7%, measles 11.7%. The national protocol for integrated management of acute malnutrition (PCIMA) was followed. This study shows that 72.3% of children were successfully treated, with 9.5% dropping out and dying, and 8.5% not responding. We found that malnutrition remains a public health problem, affecting mostly children aged 12 to 24 months. The main complications or pathologies associated with malnutrition are diarrhea, malaria, and fever, and the majority of children suffer from marasmus.

Cytogenetic Characteristics of Childhood Acute Lymphoblastic Leukemia:A Study of 1541 Chinese Patients Newly Diagnosed between 2001 and 2014

Objective:Cytogenetic abnormalities have been proven to be the most valuable parameter for risk stratification of childhood acute lymphoblastic leukemia(ALL).However,studies on the prevalence of cytogenetic abnormalities and their correlation to clinical features in Chinese pediatric patients are limited,especially large-scale studies.Methods:We collected the cytogenetics and clinical data of 1541 children newly diagnosed with ALL between 2001 and 2014 in four Chinese hospitals,and retrospectively analyzed their clinical features,prognosis and risk factors associated with pediatric ALL.

Primitive Neuroectodermal Tumor as the Second Malignant Neoplasm in a Long-Term Survivor Child of Acute Lymphoblastic Leukemia: A Case Report

Acute lymphoblastic leukemia(ALL)is a common pediatric cancer.The second malignant neoplasms(SMNs)in long-term survivors of pediatric ALL are relatively rare.Herein we report a 10-year-old girl who was diagnosed as primitive neuroectodermal tumor(PNET)5 years after the initial diagnosis of ALL with radiotherapy・free treatment.PNET is an exceedingly rare neoplasm in SMNs of survivors of childhood ALL.It is predisposed to be misdiagnosed and the pathogenesis is unclear.The outcome is poor.Long-term follow-up is necessary for the survival children of ALL.

ADE as Induction Therapy Results in Treatment of Children with Non-M3 High-Risk Acute Myeloid Leukemia, an Extrapolable Achievement in Developing Countries

Background: In Mexico, AML survival is referred in 30%. Our aim was to evaluate results with ADE protocol as induction treatment in children with non-M3 AML in a public Mexican institution. Method: We included patients with AML in a single institution between 2005 and 2013. All non-M3-AML patients received ADE as induction therapy (cytarabine 100 mg/m2 in continuous infusion from day 1 to 7, daunorrubicin 30 mg/m2 days 1, 3, 5 and etoposide 100 mg/m2 over days 1 to 5). Patients received antibiotic prophylaxis and strict scheduled appointments to assure adherence and prevent avoidable emergencies. Main Results: Eighteen patients were included. Median age was 106 months. One patient died at diagnosis so 17 were eligible for induction results analysis;eleven needed two cycles and six patients three. Remission rate was 100%. Analyzing non-M3 patients overall survival was 80.2% at 100 months. No fatal complications were observed. Stratifying by number of cycles we observe that patients receiving one ADE cycle had a 0% overall survival at short follow up, with 2 ADE cycles 80% at 100 months and with 3 cycles 100% at 60 months. Conclusion: ADE induction therapy showed improved results in overall survival compared with other standard regimens. Following the protocol we obtained 100% remission. This is an important achievement in our population. Our focus must be to ameliorate maintenance final results. These results should be reproduced in other hospitals in Mexico and other countries.

Acute lymphoblastic leukemia in a β-thalassemia intermedia child: A case report

BACKGROUNDβ-thalassemia intermedia(βTI)is one of the hemoglobinopathies.It constitutes 10%ofβ-thalassemia cases yet being associated with a better quality of life thanβ-thalassemia major(βTM).CASE SUMMARY We recently reported the first case of acute lymphoblastic leukemia(ALL)from Egypt in a child withβTM,and we herein report the first case of ALL from Egypt in a child withβTI.In this report,literature was reviewed for cases of malignancies associated withβTI and the possible factors underling the relationship between the two entities.CONCLUSION We stress that physicians should have a high index of suspicion of malignancies in thalassemia patients if they present with any suggestive symptoms or signs.

Unusual presentation of Erdheim-Chester disease in a child with acute lymphoblastic leukemia

Erdheim-Chester disease(ECD) is an uncommon, nonfamilial, non-Langerhans cell histiocytosis, which involves skeletal system and soft tissue usually in middle aged and elderly patients. The characteristic radiologic features include bilateral, symmetric cortical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones, or bilateral symmetrically abnormal intense 99 mTechnetium labelling of the metaphyseal-diaphyseal region of the long bones, and computed tomography scan findings of "coated aorta" or "hairy kidneys". ECD in childhood with osteolytic lesion is extremely rare. We describe an unusual case with an expansile lytic bone lesion at presentation in a case of acute lymphoblastic leukemia.