Topic:Anemia

Equine Piroplasmosis in Asymptomatic Horses of Western Iran: Comparison of Microscopic Examination and Multiplex PCR.
Acta parasitologica    February 29, 2024   doi: 10.1007/s11686-024-00804-3
Mohammad-Naseri A, Shokrani H, Rahmani-Shahraki A.Piroplasmosis is responsible for anemia, fever, loss of physical activity and even death in equines. In epidemiological studies, accurate diagnostic tests are essential for detecting asymptomatic carriers. This study aimed to investigate the prevalence of infection in asymptomatic horses from Lorestan province, western Iran by developing a multiplex PCR. Results: Blood samples were examined by microscopy and multiplex PCR targeting the SSU rRNA gene of Theileria equi and Babesia caballi. Out of the total of 165 horses, 19 (11.51%) and 31 (18.78%) cases were positive for piroplasms by microscop...
Development and evaluation of a test strip for the rapid detection of antibody against equine infectious anemia virus.
Applied microbiology and biotechnology    January 8, 2024   Volume 108, Issue 1 1-13 doi: 10.1007/s00253-023-12980-9
Zhang Z, Guo K, Chu X, Liu M, Du C, Hu Z, Wang X.Equine infectious anemia (EIA) is a contagious disease of horses caused by the equine infectious anemia virus (EIAV). The clinical signs at the acute phase include intermittent high fever, thrombocytopenia, hemorrhage, edema, and anemia. The clinical signs at chronic and relapsing subclinical levels include emaciation and progressive weakness. Surviving horses become lifelong carriers because of the integration of the viral genome into that of the host, and these horses can produce and transmit the virus to other animals. This increases the difficulty of imposing practical control measures to ...
Development and evaluation of a real-time quantitative PCR for the detection of equine infectious anemia virus.
Microbiology spectrum    October 9, 2023   e0259923 doi: 10.1128/spectrum.02599-23
Li S, Guo K, Wang X, Lin Y, Wang J, Wang Y, Du C, Hu Z, Wang X.Equine infectious anemia (EIA) has a worldwide distribution and causes severe economic losses to the equine industry. The EIA virus (EIAV) genome sequences from different countries are highly diverse, which poses a great challenge for pathogen identification with PCR. Phylogenetic analysis showed that although gag is the most conserved structural gene, it still has great genome variability. Currently, most existing PCR methods are designed based on the gag gene sequence and therefore do not cover all the viral strains, especially Asian EIAV strains. In this study, we developed a tat-gag-based ...
A case of equine piroplasmosis in the Tokyo 2020 Olympic Games.
Journal of equine science    September 8, 2023   Volume 34, Issue 3 93-99 doi: 10.1294/jes.34.93
Aida H, Foreman JH, Ochi A, Takizawa Y, Yamanaka T.Equine piroplasmosis is an infectious disease caused by Babesia caballi and Theileria equi. A competition horse that had been imported to the Equestrian Park for the Tokyo 2020 Olympic Games and had a fever over 40°C and severe anemia was diagnosed with equine piroplasmosis by blood smear and direct polymerase chain reaction (PCR) tests for Theileria equi. Treatment with protozoan anthelmintics and whole blood transfusion diminished the fever, improved the anemia, and allowed the horse to return home safely. Preparation for routine cases of this infection should include the development of a s...
First evidence of the incorporation of daprodustat and other hypoxia-inducible factor stabilizers into equine hair by passive transfer based on segmental quantitative analysis.
Journal of pharmaceutical and biomedical analysis    July 24, 2023   Volume 235 115600 doi: 10.1016/j.jpba.2023.115600
Ishii H, Shibuya M, Kusano K, Sone Y, Kamiya T, Wakuno A, Ito H, Miyata K, Yamada M, Leung GN.Daprodustat is a hypoxia-inducible factor prolyl hydroxylase domain (HIF-PHD) inhibitor and is used as an erythropoiesis stimulant for the treatment of anemia in humans. In general, administering daprodustat to horses will result in a lifetime ban from both equestrian sports and horseracing by the International Federation of Horseracing Authorities and the Fédération Équestre Internationale, respectively. To control the misuse/abuse of daprodustat, we conducted nasoesophageal administration of daprodustat (100 mg/day for 3 days) to three thoroughbred mares and the post-administration hair ...
Contribution of Hemogram Plan in the Horse’s Clinical Evaluation.
Journal of equine veterinary science    March 22, 2023   Volume 126 104292 doi: 10.1016/j.jevs.2023.104292
Satuu00e9 K, Fazio E, Gardu00f3n JC, Medica P.The interpretation of the blood count is essential to help the equine clinician in the diagnosis, prognosis, patient management, and control of equine diseases. Hematologic alterations often reflect the condition of the individual or an overall response to a pathological situation. A thorough clinical examination of the patient is essential to correctly interpret the hematological results. The most common abnormalities in the erythrogram are mainly anemia and polycythemia. The frequent causes of anemia in horses are acute and chronic blood loss, hemolytic anemia, and anemia caused by chronic d...
Association of globulin concentrations with prognosis in horses with lymphoma.
Frontiers in veterinary science    January 9, 2023   Volume 9 1086010 doi: 10.3389/fvets.2022.1086010
Wensley FM, Berryhill EH, Magdesian KG.Lymphoma is the most common hemopoietic neoplasia in horses. Common clinicopathologic abnormalities in equine lymphoma include hyperglobulinemia, hypoalbuminemia, hyperfibrinogenemia, anemia, thrombocytopenia and lymphocytosis. Hypoglobulinemia has been reported in other species with lymphoma, however it has not been well-described in horses. The objectives of this study were to examine the prevalence of hypoglobulinemia in equine lymphoma, and to identify prognosis and clinicopathological abnormalities associated with serum globulin concentrations. Unassigned: Ninety-six horses with lymphoma ...
Detection of Anaplasma phagocytophilum in horses from Germany by molecular and serological testing (2008-2021).
Veterinary parasitology    November 21, 2022   Volume 312 109840 doi: 10.1016/j.vetpar.2022.109840
Schu00e4fer I, Silaghi C, Fischer S, Marsboom C, Hendrickx G, Gehlen H, Mu00fcller E.Equine granulocytic anaplasmosis (EGA) is a tick-borne disease caused by Anaplasma (A.) phagocytophilum. In Germany, this pathogen is transmitted primarily by Ixodes ricinus. There is limited knowledge about its prevalence in horses in Germany. The aim of this retrospective study was to analyze the results of serological and molecular testing for A. phagocytophilum in horses which were done in a commercial laboratory in Germany over fourteen years. Additionally, risk factors were evaluated, and hematological abnormalities were addressed in horses with positive PCR results. Methods: This retros...
[Glyphosate detection in the duodenal fluid of horses with gastric ulcer syndrome].
Schweizer Archiv fur Tierheilkunde    November 4, 2022   Volume 164, Issue 11 777-788 doi: 10.17236/sat00374
Schusser GF, Ku00f6ller G, Recknagel S, Lindner A.The hay producing plants, concentrate, straw and meadows could be contaminated by the aerosols of glyphosate based herbicide during spraying process of crops and pre-harvest desiccation treatment of cereals. The aim of this study is to investigate the concentration of glyphosate in the duodenal fluid of horses with gastric ulcer syndrome. The stomach and duodenum of referred untreated horse patients (n=92) with colic, weight loss, diarrhoea, anemia or performance intolerance were endoscopically examined right after the admission. Duodenal fluid (40 ml) was collected from the duodenal region ...
Theileria equi in the horses of Iran: Molecular detection, genetic diversity, and hematological findings.
Veterinary parasitology, regional studies and reports    October 5, 2022   Volume 36 100792 doi: 10.1016/j.vprsr.2022.100792
Kalantari M, Sharifiyazdi H, Ghaemi M, Ghane M, Nazifi S.In all equids worldwide, Theileria equi and Babesia caballi are believed to be two important erythrocytic protozoa that cause equine piroplasmosis. In addition, it was recently discovered that Theileria haneyi is another potential equine piroplasmosis (EP) agent. Ixodid ticks are the major vectors of these parasites. Equine piroplasmosis is of international importance and affects enormously the equine industry. In this study, for the first time, molecular prevalence and genetic diversity of piroplasma parasites (T. equi and B. caballi) in horses from Fars province (south of Iran) were determin...
Blood Transfusion in Equids-A Practical Approach and Review.
Animals : an open access journal from MDPI    August 23, 2022   Volume 12, Issue 17 2162 doi: 10.3390/ani12172162
Jamieson CA, Baillie SL, Johnson JP.Transfusion medicine is a crucial part of equine intensive and critical care. Blood transfusions can save lives in both acute and chronic cases of anemia, hemorrhage, and hemolysis. It is vital to have a comprehensive theoretical and practical understanding of the techniques, implications, risks, and complications. This review covers the physiology and pathophysiology of conditions requiring transfusion, as well as step by step guidance for practitioners of all experience levels. This review is designed to serve as a practical reference for those who are treating horses in either the field or ...
Collection and administration of blood products in horses: Transfusion indications, materials, methods, complications, donor selection, and blood testing.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    January 20, 2022   Volume 32, Issue S1 108-122 doi: 10.1111/vec.13119
Radcliffe RM, Bookbinder LC, Liu SY, Tomlinson JE, Cook VL, Hurcombe SDA, Divers TJ.Blood transfusion is a lifesaving treatment for horses with acute hemorrhage and other causes of anemia. Transfusions improve oxygen delivery to the tissues via increased blood volume and hemoglobin concentration. Certain aspects of equine blood transfusion are challenging, especially in the field situation, and practitioners may be unfamiliar or feel overwhelmed with the process. An understanding of the indications, materials, methods, and techniques as well as donor selection and possible complications will help practitioners successfully implement blood transfusion in clinical practice. Met...
Subleukaemic T-Lymphoblastic Leukaemia in a Horse.
Journal of comparative pathology    September 14, 2021   Volume 188 21-25 doi: 10.1016/j.jcpa.2021.08.002
Michishita M, Shibata R, Machida Y, Matsumoto M, Ochiai K, Azakami D.A 20-year-old Dutch Warmblood gelding was referred with clinical signs of anorexia, weight loss, intermittent fever, cough, subcutaneous oedema and exercise intolerance. Haematological examination revealed the presence of blast cells, decreased lymphocytes, mild thrombocytopenia and anaemia but no leucocytosis. Serum analyses detected elevated aspartate aminotransferase and gamma-glutamyl transferase activities and triglyceride concentrations. Twenty-two days after the initial visit, the horse died after showing clinical signs of decreased appetite, increased body temperature, tachypnoea and t...
Copper Toxicity in Horses: Does it Exist?
Journal of equine veterinary science    August 30, 2021   Volume 106 103752 doi: 10.1016/j.jevs.2021.103752
Belli CB, Fernandes WR, Torres LN, Sucupira MCA, de Su00e1 LRM, Maiorka PC, Neuenschwander HM, de Barros AMC, Baccarin RYA.Copper toxicity is thought to be a rare condition in horses. However, the number of cases diagnosed in Brazil is growing. This article aims to describe cases of copper toxicity involving horses from different geographic locations and discuss findings of physical examinations, differential diagnoses and potential causes. Five cases referred from 4 different properties where at least 15 other horses were affected were described. Hemolytic anemia and hemoglobinuria, presence of Heinz bodies and elevated aspartate aminotransferase and gamaglutamil transferase levels were detected in all cases. The...
Identification of Hypoxia-inducible factor (HIF) stabilizer roxadustat and its possible metabolites in thoroughbred horses for doping control.
Drug testing and analysis    February 23, 2021   Volume 13, Issue 6 1203-1215 doi: 10.1002/dta.3014
Mathew B, Philip M, Perwad Z, Karatt TK, Caveney MR, Subhahar MB, Karakka Kal AK.Hypoxia-inducible factor (HIF) stabilizer belongs to a novel class of pharmacologically active substances, which are capable of inducing the endogenous erythropoietic system. The transcriptional activator HIF has been shown to significantly increase blood hemoglobin and is well set for the treatment of anemia resulting from chronic kidney disease. This research work reports a comprehensive study of the most popular HIF stabilizer roxadustat and its metabolites in thoroughbred horse urine after oral administration. The plausible structures of the detected metabolites were postulated using liqui...
Immune-mediated haemolytic anaemia and thrombocytopenia in 25 adult equids: 1997-2016.
Equine veterinary journal    December 3, 2020   Volume 53, Issue 5 964-971 doi: 10.1111/evj.13384
Easton-Jones CA, Estell KE, Magdesian KG.Information concerning clinical presentation, conditions associated with immune-mediated haemolytic anaemia (IMHA) and thrombocytopenia (IMTP) and outcome in equids is lacking. Previous case reports suggest that immune-mediated disease and neoplasia are associated. Objective: Characterise the clinical presentation, clinicopathologic data, underlying conditions, treatment and outcome of IMHA and IMTP cases in equids. We hypothesise that IMHA with concurrent thrombocytopenia occurs more often than IMHA or IMTP alone, and that neoplasia is commonly associated with these immune diseases and cases ...
Acupuncture for Anaemia and Large Intestine Impaction Associated with Hind Limb Weakness in a Horse: A Case Report.
Journal of acupuncture and meridian studies    November 28, 2020   Volume 13, Issue 6 187-190 doi: 10.1016/j.jams.2020.11.002
Resano-Zuazu M.A 24-year-old horse was presented with a clinical history of anaemia, large intestine impaction and hind limb weakness. Loss of body weight was also reported. Hematocrit and hemoglobin levels were low and piroplasmosis test was negative. Nasogastric intubation with laxative agents was performed and 50 ml of a red blood-cell-supplement was given daily during a month. An assessment following Traditional Chinese Veterinary Medicine (TCVM) principles was performed after the last episode of large intestine impaction. A swollen, pale and wet tongue was observed. A superficial, weak pulse combined p...
First case report on the occurrence of Trypanosoma evansi in a Siam B Mare in Kelantan, Malaysia.
Veterinary medicine and science    November 7, 2020   Volume 7, Issue 2 303-309 doi: 10.1002/vms3.379
Mohd Rajdi NZI, Mohamad MA, Tan LP, Choong SS, Reduan MFH, Hamdan RH, C W Zalati CWS.This is the first case report for the positive Trypanosoma evansi incident in Kelantan, Malaysia confirmed through protozoa detection in a Siam B mare. The horse was presented with complaints of lethargy and inappetence and it collapsed on the day of visit. Normal saline and dextrose solution were administered intravenously, while multivitamins and nerve supplements were given intramuscularly to stabilise the horse before further treatment. Haematological findings showed normocytic hypochromic anaemia and are suggestive of regenerative anaemia. Thin blood smear and examination revealed the pre...
Nutritional Supplements Containing Cardus mariano, Eucalyptus globulus, Gentiana lutea, Urtica urens, and Mallotus philippinensis Extracts Are Effective in Reducing Egg Shedding in Dairy Jennies (Equus asinus) Naturally Infected by Cyathostomins.
Frontiers in veterinary science    November 5, 2020   Volume 7 556270 doi: 10.3389/fvets.2020.556270
Arfuso F, Bazzano M, Brianti E, Gaglio G, Passantino A, Tesei B, Laus F.The increasing levels of anthelmintic resistance together with the restrictions in the use of drugs in food producing animals have enforced the search for sustainable alternative approaches for parasite control. The current study aimed to investigate the safety and the efficacy of a commercially available phytotherapic formulation against gastrointestinal strongyles in donkeys. Twenty-two Ragusana jennies (2.6 ± 0.5 years old) were assigned to two equal groups. One group was treated with two doses of a phytotherapic supplement Paraxitebio® containing , and , 14 days apart (Group A). One grou...
Outbreak of acute larval cyathostominosis – A “perfect storm” of inflammation and dysbiosis.
Equine veterinary journal    October 6, 2020   Volume 53, Issue 4 727-739 doi: 10.1111/evj.13350
Walshe N, Mulcahy G, Crispie F, Cabrera-Rubio R, Cotter P, Jahns H, Duggan V.Cyathostomins are prevalent and pathogenic intestinal helminths of horses, causing acute and chronic disease, including acute larval cyathostominosis, which has a mortality rate of 50%. Factors determining individual susceptibility to acute larval cyathostominosis are unknown. Investigation of these factors could lead to novel treatment and prevention strategies. Objective: To investigate clinicopathological and faecal microbiota changes associated with disease in individual horses in an acute larval cyathostominosis outbreak. Methods: Case series. Methods: The study population was a herd of 2...
Serological and molecular detection of Anaplasma phagocytophilum in Thoroughbred horses from Chilean racecourses.
Ticks and tick-borne diseases    April 16, 2020   Volume 11, Issue 4 101441 doi: 10.1016/j.ttbdis.2020.101441
Hurtado C, Torres R, Pu00e9rez-Macchi S, Sagredo K, Uberti B, de Souza Zanatto DC, Machado RZ, Andru00e9 MR, Bittencourt P, Mu00fcller A.Anaplasma phagocytophilum is the causative agent of equine granulocytic anaplasmosis (EGA). This study aimed to perform serological and molecular surveys of A. phagocytophilum in thoroughbred horses from racecourses in Chile. Additionally, hematological findings related to A. phagocytophilum molecular positivity were addressed, and phylogenetic analysis of selected positive samples was performed. Complete blood count and msp2 gene real-time PCR were performed in 457 thoroughbred horses from three racecourses located in three different cities of Chile (Santiago, Viña del Mar and Concepción). ...
Acute kidney injury due to Leptospira interrogans in 4 foals and use of renal replacement therapy with intermittent hemodiafiltration in 1 foal.
Journal of veterinary internal medicine    January 30, 2020   Volume 34, Issue 2 1007-1012 doi: 10.1111/jvim.15713
Fouchu00e9 N, Graubner C, Lanz S, Schweighauser A, Francey T, Gerber V.Four 2-month-old foals were presented to an equine hospital with acute kidney injury caused by Leptospira interrogans infection. Clinical signs were nonspecific and included lethargy, fever, and unwillingness to nurse. The most important hematologic and clinicopathologic findings were azotemia, anemia, thrombocytopenia, hyponatremia, and hypochloremia. The diagnosis was based on urinary real-time PCR, serology using a microscopic agglutination test, or both. The most important serovars involved were L. interrogans serogroup australis serovar Bratislava and Australis. Treatment consisted of IV ...
Hematology Red Flags: The Value of Blood Smear Examination in Horses.
The Veterinary clinics of North America. Equine practice    January 18, 2020   Volume 36, Issue 1 15-33 doi: 10.1016/j.cveq.2019.11.001
Stokol T.This article uses a case-based approach, complemented with diagnostic algorithms and images, to highlight hematologic changes of pathologic relevance in horses, namely, marked erythrocytosis, anemia or leukocytosis, inflammatory leukograms, lymphocytosis in adult horses, thrombocytopenia, and pancytopenia. These hematologic abnormalities occur with certain diseases and their identification can help clinicians narrow to down differential diagnostic lists. This article highlights the importance of blood smear examination, particularly, but not only, when numerical red flags are identified on aut...
The occurrence of hemotropic Mycoplasma ovis-like species in horses.
Preventive veterinary medicine    December 23, 2019   Volume 175 104877 doi: 10.1016/j.prevetmed.2019.104877
Kalantari M, Sharifiyazdi H, Ghane M, Nazifi S.Hemotropic mycoplasmas (haemoplasmas) are wall-less bacteria, which may lead to anemia and, even, mortality in mammals. The present study was aimed to characterize the causative agent(s) of haemoplasma infection in blood samples taken from horses (n = 133) in south of Iran. Microscopic examination of blood smears and PCR assay were performed for the detection of hemotropic Mycoplasma and equine piroplasma (Babesia caballi and Theileria equi). For the purpose of molecular characterization, 16S rDNA and 18S rDNA markers were used for hemotropic Mycoplasma and piroplasma pathogens, respective...
Serological, molecular and hematological diagnosis in horses with clinical suspicion of equine piroplasmosis: Pooling strengths.
Veterinary parasitology    September 20, 2019   Volume 275 108928 doi: 10.1016/j.vetpar.2019.108928
Camino E, Dorrego A, Carvajal KA, Buendia-Andres A, de Juan L, Dominguez L, Cruz-Lopez F.Equine piroplasmosis (EP) is a tick-borne protozoan disease caused by Theileria equi and/or Babesia caballi. Clinical signs (fever, pale mucosal membranes, jaundice), anemia and hyperbilirubinemia have been associated with the disease. EP is widespread, has a significant economic impact on the equine industry and remains endemic in Spain. This study was carried out with samples belonging to 140 horses residing in Spain and showing common clinical signs of EP. A blood smear microscopic examination and a comparison between the different results obtained by competitive Enzyme-Linked Immunosorbent...
Malignant Mesothelioma of the Vaginal Tunic and Peritoneum in a Young Stallion.
Journal of equine veterinary science    July 19, 2019   Volume 80 76-79 doi: 10.1016/j.jevs.2019.07.008
MacMillan KM, Martinson SA, Smith M, Lofstedt J.Mesothelioma is a rare malignancy in horses. This report describes a case in which marked hemoperitoneum, moderate anemia, and moderate dependent edema were the presenting clinical signs in a 2-year-old Standardbred stallion with mesothelioma of the vaginal tunic. On necropsy, approximately 40 L of dark red fluid distended the abdomen. A dark red mass infiltrated and effaced the right pampiniform plexus, and red nodular masses were present multifocally on the parietal and visceral peritoneal surfaces. Histopathologically, the masses were composed of malignant spindle cells with a sarcomatoid ...
First Report of Acute Bilateral Hyphema in a Theileria equi-Infected Kathiawari Horse.
Journal of equine veterinary science    March 6, 2019   Volume 77 72-74 doi: 10.1016/j.jevs.2019.02.021
Prasad A, Kumar V, Kumar B.Theileria equi is a tickborne hemoparasite that can cause severe illness in equids. In this report, we are describing a condition of acute bilateral hyphema in a 4-month-old Kathiawari filly infected with T. equi. The horse showed clinical signs such as fever, lethargy, icterus, tachycardia, tachypnea, and bilateral hyphema. Laboratory diagnosis revealed anemia and thrombocytopenia. Atypical clinical manifestation of bilateral hyphema, to our knowledge, has never been reported so far in equids infected with T. equi. The diagnosis was confirmed by microscopic examination of Geimsa-stained blo...
κ Light-chain monoclonal gammopathy and cast nephropathy in a horse with multiple myeloma.
Journal of the American Veterinary Medical Association    October 13, 2018   Volume 253, Issue 9 1177-1183 doi: 10.2460/javma.253.9.1177
Eberhardt C, Malbon A, Riond B, Schoster A.CASE DESCRIPTION A 27-year-old Dutch Warmblood mare was evaluated because of a history of lethargy, reluctance to move, weight loss, persistent hyperproteinemia, and recurrent episodes of mild lameness. CLINICAL FINDINGS Hematologic evaluation revealed anemia (RBC concentration, 3.84 × 10 cells/μL), thrombocytopenia (47 × 10 thrombocytes/μL), and hyperproteinemia (total protein concentration, 11.2 g/dL) with hyperglobulinemia and hypoalbuminemia. Results of protein electrophoresis of serum and urine samples indicated a monoclonal gammopathy; the paraprotein was identified as a κ light cha...
Seroprevalence and Risk Factors for Theileria equi Infection in Equines from Khyber Pakhtunkhwa Province, Pakistan.
Iranian journal of parasitology    January 11, 2018   Volume 12, Issue 4 597-605 
Afridi MJK, Mian AH, Saqib M, Abbas G, Ali J, Mansoor MK, Sial AUR, Rasheed I, Hussain MH. is a tick borne protozoan parasite which causes piroplasmosis among equines worldwide. The present study was aimed to determine seroprevalence of in donkeys, horses, and mules from two equine populated districts (Peshawar and Charsadda) of Khyber Pakhtunkhwa (KPK), Pakistan. Methods: A total of 393 equine (195 horses, 194 donkeys and 4 mules) serum samples were collected from five and four randomly selected localities in Charsadda (n = 193) and Peshawar (n = 200), respectively. The presence of antibodies to was determined using a commercially available competitive enzyme-linked immunosorben...
Acute Leukemia in Horses.
Veterinary pathology    August 16, 2017   Volume 55, Issue 1 159-172 doi: 10.1177/0300985817720983
Cooper CJ, Keller SM, Arroyo LG, Hewson J, Kenney D, Bienzle D.Leukemia is broadly divided into acute and chronic lymphocytic and myeloid types based on the proportion of blasts, morphology of cells, and expression of specific antigens on neoplastic cells. Classifying leukemia in horses can be challenging if blasts predominate and since few antibodies to identify cell types are available. The objective of this study was to describe in detail the clinical and pathologic features of acute leukemia in horses. Twelve horses ranging from 0.2 to 25.9 years of age were diagnosed with acute leukemia. Six cases were classified as acute lymphocytic leukemia (ALL) b...
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