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October 4, 1965

Infectious Mononucleosis in Acute Lymphocytic Leukemia

Author Affiliations

From the Hematology-Chemotherapy Clinic, Walter Reed General Hospital, Washington, DC.

JAMA. 1965;194(1):27-29. doi:10.1001/jama.1965.03090140035009

An 18-year-old high-school student was found to have lymphoblastic leukemia at the age of 16 years. Remission was obtained with weekly doses of 2 mg/sq m of body surface of vincristine sulfate and daily doses of 40 mg/ sq m of prednisone. Maintenance treatment with intramuscular administration of methotrexate, 30 mg/sq m twice weekly, was initiated, after which febrile episodes developed on three occasions. It is believed that they were related to the drug. After the leukemia had been in remission for about one year, infectious mononucleosis developed and the patient had marked elevation of heterophil antibody titer without adsorption by guineapig kidney. Only one similar case was found in the literature. One case of lymphoblastic leukemia was preceded by infectious mononucleosis. At the time of this report, the patient's leukemia has been in remission for over two years.