Early T-cell precursor (ETP) acute lymphoblastic leukemia (ALL), was first identified within cases of childhood T-ALL based on its unique immunophenotypic and genetic features of limited (early) T-cell differentiation associated with (some) myeloid and stem cell features. 1 Thus ETP-ALL blasts express CD7, dim CD5 (<75% positive cells), in the absence of CD1a and CD8, and positivity for ≥1 myeloid/stem cell related markers (i.e., CD34, CD13 or CD33). 1,2 In turn, ETP-ALL frequently shows myeloid-associated gene alterations such as FLT3, NRAS/KRAS, DNMT3A, IDH1 and IDH2 mutations, 3,4 with lower frequencies of other T-ALL-associated mutations (e.g., NOTCH1 and CDKN2A/B gene mutations). 5,6 The World Health Organization (WHO) 2016 classification of ALL included ETP-ALL for the first time, as a provisional entity, 7 but it failed to establish robust diagnostic criteria. Thus, after the first immunophenotypic characterization of ETP-ALL by Coustan-Smith et al. 1 the proposed criteria did not allow identification of all ETP-ALL cases as detected by gene expression profiling. 2 In addition, the "partial CD5 expression" criterion had a negative impact on the reproducibility of ETP-ALL diagnoses because of the lack of standardization of the method used for its assessment. Because of this, Zuubier et al. proposed refined immunophenotypic criteria by excluding CD5 expression while adding negativity for CD4. 2 From the clinical point of view early studies based on limited numbers of pediatric patients indicated that ETP-ALL was associated with a very poor outcome. 1,8,9 More recent data, based on larger series of children treated with more intensive therapy, showed no significant differences in outcome for ETP-ALL vs. other T-ALL cases. 10 In contrast, limited data have been reported for adult ETP-ALL, with conflicting results. 11,12 In one study, adult ETP-ALL was associated with a worse prognosis following different frontline chemotherapy schedules. 11 The

previous infusion of rituximab without grade 3 or 4 toxicity, lymphoid cells <5 x 10(9)/L and rituximab dose of 375 mg/m(2). Seventy patients were treated with a total of 319 rapid rituximab infusions [126 (40%) with and 193 (60%) without steroids]. Overall, rapid infusion of rituximab was well tolerated - there were no grade 3 or 4 adverse events. Only, three patients developed symptoms, all grade 1. In conclusion, rituximab administration in a 90-min infusion schedule is well tolerated and safe, both in patients who are administered steroids and in patients who are not.

Highlights Chronic kidney disease develops in up to 25% of patients with cirrhosis who survive an episode of acute kidney injury. Risk factors for the development of chronic kidney disease are nosocomial acute kidney injury and increased severity. Transition to chronic kidney disease is associated with increased risk of acute kidney injury, cirrhotic complications and hospital re-admissions.