Review Article

Acute Lymphocytic Leukemia after Fulminant Varicella Associated with Severe Neutropenia

Authors: Bushra Moiz, MBBS, MCPS, FCPS


To the Editor:

In my opinion, the patient described in the article by Helft et al 1 had leukemia to start with, because the patient was in a pancytopenic state. In addition, trephine bone marrow biopsy was not performed, so the leukemia could have been missed, especially if the marrow was patchily hypoplastic. Moreover, the high serum lactate dehydrogenase and CD 10 positivity also favor a diagnosis of leukemia. The role that growth factors played in the genesis of full-blown cancer is difficult to determine. I think that all patients with pancytopenia should undergo trephine biopsy so that the real diagnosis can be made.

Bushra Moiz, MBBS, MCPS, FCPS

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1. Helft DA, Correa H, Rojas P, Warrier RP. Acute lymphocytic leukemia after fulminant varicella associated with severe neutropenia. South Med J 2002; 95: 1074–1075.