We present the incidence and the immunologic characteristics of acute lymphoblastic leukemia (ALL) subsets in Moroccan children. We studied 279 unselected patients below the age of 18 years with newly diagnosed ALL. Cases were classified according to immunophenotype: 216 (77.42%) precursor B-cell phenotype (pB-cell), mature B-cell in 4 (1.43%), and T-cell in 59 (21.15%) cases. The subclassification using the CD10 antibody revealed 197 cases pB-ALL CD10+ (91.2%) and 9 cases T-ALL CD10+ (19.2%). The age distribution showed a peak in incidence between 3 and 5 years among the pB-cell ALLs subtype. There was a significantly higher frequency of males in the T-ALL subset (M/F ratio: 2.93 : 1) and more females in the T-ALL CD10+ subset when compared with the T-ALL CD10– subset. All tested pB-cell-lineage ALLs expressed CD19, CD79a, and surface CD22, terminal deoxynucleotidyl transferase (TdT) was detectable in 89.9% of cases, and cells in 74.1% of cases express CD34. All tested T-lineage ALL cells have surface CD7 and cytoplasmic CD3 (cCD3) antigens, CD5 was found in 98.2% cases, and 70.5% express TdT. CD1a, surface CD3 (sCD3), and CD4 are detected in more than 80% of cases; this frequency is higher than the 45% generally observed. Myeloid antigens occur more frequently and were expressed in 124 (57.4%) of pB-cell-ALL cases and 20 (33.9%) of T-cell ALL cases. Our results show that the distribution of ALLs in Moroccan children is similar with the general distribution pattern in developed countries except for the high frequency of T-ALL phenotype. The phenotypic profiles of our patients are close to those reported in literature for B-lineage ALLs; for the T-cell ALL subgroup, the blast cells express more CD1a, surface CD3, and CD4 while expressing less TdT. The high frequency of CD1a expression resulted in an excess of the common thymocyte subtype.

Introduction Nutritional assessment is an essential component of the initial assessment of children with cancer. Malnutrition may be present at diagnosis due to the effects of the malignancy or, in low income countries (LIC), due to poverty and an inadequate diet. Purpose The aim of this study is to evaluate the prevalence of malnutrition at diagnosis in children with cancer in Morocco. Procedure Nutritional status of 100 children aged less than 18 years with newly diagnosed malignancy between January 2005 and January 2006 was evaluated by anthropometric and biochemical parameters before initiating therapy. We measured weight, height, weight-for-height using z-scores index for children and body mass index for adolescents, triceps skinfold thickness and mid-upper arm circumference, and serum albumin. Results A total of 100 patients were included. The mean age was 7 years (range 1 to 18 years). Sixty percent were boys. The diagnosis was: Burkitt lymphoma (n=19), acute myeloblastic leukaemia (n=18), acute lymphoblastic leukaemia (n=14), rhabdomyosarcoma (n=13), Ewing sarcoma (n=7), nephroblastoma (n=6), Hodgkin disease (n=5), osteosarcoma (n=5), retinoblastoma (n=4), neuroblastoma (n=3), germ cell tumor (n=3), orbital lymphoma (n=1), cerebral lymphoma (n=1), ependymoma (n=1). Incidence of malnutrition ranged from 20–50%, depending upon the measurement used. Conclusion The prevalence of malnutrition in this study was high, so interventions are being implemented to improve the nutritional status of these patients.

These results are encouraging for a developing country but special efforts should be done to reduce the rate of abandonment.

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We report a 16-year-old male with a combination of pernicious anemia, auto-immune hemolytic anemia and alopecia areata. Autoimmune hemolytic anemia coexisted with pernicious anemia but was diagnosed only when the anemia failed to respond to cobalamin therapy. Alopecia areata occurred 9 years later.