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Background Xeroderma pigmentosum is a rare inherited disease characterized by extreme hypersensitivity to ultraviolet rays and predisposing to cutaneous malignancies that can appear in childhood. These manifestations are often associated with ocular lesions and sometimes with neurological disorders. The association of xeroderma pigmentosum with internal neoplasms such as acute myeloblastic leukemia is not reported with great frequency, which confirms the rarity of this occurrence. Case report A 26-year-old Moroccan women, xeroderma pigmentosum patient, was diagnosed with acute myeloblastic leukemia with a complex karyotype. Due to the adverse risk of the xeroderma pigmentosum association with acute myeloblastic leukemia and the profile of acute myeloblastic leukemia with complex karyotype and monosomy 7, which constitute factors of poor prognosis, as well as the absence of studies conceding the tolerance of the chemotherapy by patients suffering from xeroderma pigmentosum, our patient was put under low-dose cytarabine protocol with granulocyte colony-stimulating factor. Unfortunately, she died on the tenth day of chemotherapy by acute pulmonary edema of cardiogenic pace complicated by tamponade. Conclusion According to reports, it is the second case showing association of xeroderma pigmentosum with acute myeloblastic leukemia. The management of these patients remains a challenge. Studies focusing on xeroderma pigmentosum patients developing hematological malignancies are necessary to better understand the most appropriate strategies and precautions for this specific case.

According to the World Health Organization, medulloepithelioma belongs to the embryonal neoplasm entity. It is a very rare, highly malignant tumor typically affecting infants and young children. Usually, the tumor arises in the eye or in the central nervous system; a peripheral location has been rarely reported without an established treatment. The recognition and separation of this neoplasm from other differential tumors are mandatory for better understanding of its biology and determination of optimal treatment. This paper reports a case of an ectopic intrapelvic medulloepithelioma with liver metastasis in a 3-year-old girl.

Cutaneous diffuse B-cell lymphoma leg type is a rare entity, it represents approximately 5% of primary cutaneous lymphomas. It has a poor prognosis. We report case of t 58 years old patient with a cutaneous B cell lymphoma leg type with dual location at the upper and lower limbs and bone lysis. Histological examination of the skin biopsy showed diffuse lymphomatous proliferation dissecting collagen, made of large cells with abundant cytoplasm moderately ill-defined, ovoid nuclei and with a discreet nuclear irregularity. The immunohistochemical study revealed lymphoma cells phenotype B with a homogeneous expression of CD 20, a homogeneous expression of CD 3, CD 43 positive. Bcl 2 was positive, asthe Bcl 6 and Mum 1. CD 5, CD10, MPO, CD 34, and Tdt were negative. The Ki 67 was positivein90%. The staging showed extensive osteolysis of the lower end of the humerus and the ulna. The patient received 2 courses RCHOP, with faillure of treatment, and then she received one course of RDHAP before dying. The particularity of this observation consists in the age; our patient was younger than the average, and the double localization of lymphoma in both arm and leg, with osteolysis. We discuss also the difficulties of treatment of this disease.

Treatment of acute myeloblastic leukemia in children, adolescents and young adults (AYA) is a challenge in low-income countries. To evaluate treatment outcomes of children (≤ 15 years) and AYA (15–30 years) diagnosed with novo AML and treated in a single center according to the AML-MA 2011 protocol. From January 2011 to December 2015, eligible patients (age ≤ 30 years) with novo AML had been enrolled on a uniform treatment protocol. The diagnosis was confirmed according to the FAB classification using the WHO 2008 criteria. Patients with WBC ≥ 50 G/L had pretreated 4 days of hydroxyurea followed by two inductions and two consolidations. Supportive care consisted of transfusion of labile blood products, antibiotics and antifungals, and patient and family education by the hygiene team. 155 patients were recruited, 41 were

Resume Introduction L’isolement medical est une mesure commune de prevention et de controle des infections liees aux soins, cependant ses effets sur le bien-etre psychologique des patients sont souvent negliges. Peu d’etudes ont evalue de maniere prospective les repercussions psychologiques de l’isolement en hematologie. La prise en compte de ces consequences est fondamentale. L’objectif du present travail est d’evaluer l’attitude des patients a l’egard des mesures d’isolement et de reperer des axes d’ameliorations. Methodes C’une etude prospective etalee sur deux mois, incluant des patients âges ≥ 18 ans mis en isolement, n’ayant pas d’antecedents psychiatriques. Les symptomes d’anxiete et de depression ont ete evalues a l’aide de la version Arabe de l’Echelle Hospitaliere d’Anxiete et de Depression (HADS) validee. Pour evaluer la maniere dont laquelle les malades vivent l’isolement, un questionnaire qualitatif a ete developpe. Resultats Parmi les 35 participants, l’isolement etait decrit comme un fardeau chez 31,4 % des malades dont quatre patients repondaient aux criteres diagnostiques d’un trouble psychiatrique selon l’echelle HADS. Parmi les cas, 14,3 % ont declare que l’isolement n’est pas une contrainte, mais plutot l’hospitalisation. La maladie a ete nommee comme etant le souci et la reelle preoccupation chez 54,3 % des patients. Conclusion Grâce a un programme educatif sur l’hygiene et nutrition et le cote spirituel de cette population, l’isolement n’influencait que peu les niveaux d’anxiete et la qualite de vie des patients, puisque la majorite etaient satisfaits des soins fournis et avaient une attitude positive envers les precautions prises.

Objectif : les infections associees aux soins (IAS) representent une cause majeure de morbidite et de mortalite en oncologie pediatrique. L’objectif de ce travail etait d’en determiner l’incidence a l’unite d’hematologie-oncologie pediatrique au Centre hospitalier universitaire de Casablanca. Methodes : les IAS etaient considerees selon les criteres ajustes definis par le Centers for disease control and prevention. Les facteurs extrinseques et les informations specifiques des episodes infectieux ont ete recueillis prospectivement entre janvier et aout 2011. Resultats : le taux d’incidence etait de 28/1 000 jours d’hospitalisation. La leucemie aigue myeloblastique a constitue le premier diagnostic (32 %). La neutropenie et l’acces veineux central etaient correles a un risque statistiquement significatif d’infection. L’infection etait d’origine inconnue dans 55,7 % des cas. Les bacilles gram negatifs etaient predominants (60 %). La duree d’hospitalisation etait significativement prolongee de 11,5 jours. L’incidence des deces par infection etait de 2 %. Conclusion : la surveillance des IAS nous permet d’instaurer et de determiner les axes de prevention.

Background Overall survival from leukemia is less in low and middle-income countries than in high-income countries. Our purpose was to describe the incidence, clinical features, and mortality of febrile illness with or without documented infection in children and young adults treated for AML and ALL in two centers in Rabat and Casablanca during 2011. Methods This retrospective cohort study included patients

Introduction :With the improvement in the risk assessment, therapeutic advances and supportive care, about 50% of children and young adults with newly diagnosed acute myeloid leukemia(AML) can be cured in high income countries. However similar survival advantages are not seen in patients from low or middle income countries. In Morocco, the main causes of poor outcome in patients with AML are delayed diagnosis, early (before the start of treatment) and induction death, induction failure and therapy abandonment. In 2011, the National AML-MA-2011 protocol was developed to treat AML patients according to international standards and has focused on improving particularly supportive care, prevention and management of infection, transfusion support, implementation of hand hygiene, and education of patients, families and nurses. The goals of the AML-MA-2011 protocol were to obtain of favorable risk AML more than 70% complete remission rate, less than 10% on therapy mortality and event free survival (EFS) (4 years) of 40%. Aim of this study : To evaluate and compare treatment outcomes (Complete remission rate, overall survival [OS] and EFS) of children (≤ 15 yrs.) and adolescents and young adults (AYA) (15-30 yrs) diagnosed with de novo AML and treated at a single center on AML-MA 2011 Patients and methods : From January 2011 to December 2015, eligible patient (age ≤ 30 yrs) with de novo AMLwere enrolled ona uniform treatment protocol. Patients with secondary AML, Down syndrome, those with acute promyelocytic leukemia or organ dysfunctions were excluded. The diagnosis was confirmed according to the FAB classification using WHO criteria, At diagnosis BM MPO staining, immunophenotyping and lumbrteritisar puncture were performed. Karyotype was performed on marrow sample (with minimum 20 metaphases analyzed) using R banding technique. Patients with hyperleukocytosis (WBC≥ 50G/L) received as a pre-phase 4 days of hydroxyurea to 50mg/kg/day then 2 inductions and 2 consolidations. The two courses of induction associated cytarabine (100mg/m² q 12h for 10 days), Daunorubicin (50 mg/m² on days 2, 4, 6 for the first course, and on days 1, 3, 5 for the second course) and etoposide (100mg/m² for 5 days for the second course of induction). The consolidation included Cytarabine (3g/m²q 12h days1-3 for first and second course) plus Daunorubicin (30mg/m² on days 3, 4 at the first consolidation). L-Asparaginase 6000UI/m² on day 4 was give at second consolidation. All patients received CNS prophylaxis. Patients with CNS disease received addutional intrathecal. The supportive care consisted of blood product transfusion, antibiotic and antifungal, and patient and family education by hygien team. Complete remission (CR) was defined as normal clinical examination, no evidence of chloroma, peripheral counts recovery (ANC ≥ 1.0 G/L ; platelets ≥ 75 G/L without transfusion) and end of induction II bone marrow showed normal hematopoietic elements and Résultats :During the study period a total of 155 patients were enrolled, 41 were < 15 yrs (22 boys ; median age 7.8 yrs.). Of the 114 AYA enrolled, 48 were women and the median age was 23 yrs. In children median hemoglobin was 6.75g/dl and platelet 39.5G/L, 15/41 (36.6%) had AML2 and 36/41 (87.8%) had immunophenotyping. Among young adults 32/114 (28.1%) were hyperleucocytosis, 7.38g/dl and 52.81G/L were median hemoglobin and platelets respectively, 31/114 (29.8%) had AML1 and 89/114 (78.1%) had immunophenotyping. Cytogenetics was performed 90.2% of children and 95.6% of AYA. The median delay from diagnosis to treatment was 11.5 days in children and 29.9 days. Complete remission after two inductions was achieved in 28/41 (68.3%) children and 71/114 (62.3%) adults. The number of failure was 21 in age groups which 4 (9.8%) on children and 17 (14.9%) in young adults. The number of deaths in children is 9 (22%) of which 3 occurred in the first 15 days of induction and 6 from the 15th to 42nd day. AYA 26 (22.8%) deaths had been seen by registered including 5 in the first 15 days and 21 after. The causes of death were dominated by infections including 4 cases in children and 10 adults followed hemorrhage 3 cases among children and 10 adults. Leukostasis cases were recorded in 2 children 6 and young adults. Analysis of the results is summarized in the table. Conclusion : The therapeutic results of the protocol AML-MA 2011 were similar in both year groups, but are far from the goals of treatment. Disclosures No relevant conflicts of interest to declare.

Introduction : The treatment of Acute Myeloid Leukemia (AML), in developing countries is characterized by high rate of death during induction cycles. In 2011, the Morocco National AML-MA-2011 Protocol was initiated to treat AML patients according to international standards and was focused on the improvement of supportive care with particular the prevention and management of infection, transfusion support, and, the hand hygiene education of patients, families, and health care providers. One of the objectives of the new protocol was to reduce the induction mortality rate to 10%. This report evaluates the etiology of mortality during AML treatement from 2011 to 2015 in Casablanca Hematology Departement and the impact of improvement of supportive care on the outcome of AML patients. Patients and methods : Were reviewed the data ofpatients (aged 18-60yrs) treated according to AML-MA-2011 protocol from 1st january 2011 to 31th december 2015. Patients with APL or secondary AML were excluded. In 2011 and 2012 patients were hospitalized in conventional rooms without any precautions. At the begining of 2013 to 2015 patients were hospitalized in protected unit, in single rooms with filtered and controlled air. Access to the protected unit is only reserved for medical staff with strict isolation precautions. A group of specialists in hospital hygien and microbiology was established to control, to conduct periodic evaluations, and publish new recommendations hand for washing and hygien. This group also educated patients families and health care providers. Platelet support was provided in the case of bleeding, or whenever the platelet count was less than 10 × 109/L. For infections, Ceftazidime was the first line of antibiotic used. Amikacin was added for persistent fever beyomd 48-h or clinical deterioration. Imipenem was used for persistent fever. Additional antibiotic or antifungal or antiviral was dictated by clinical and biological findings. The Early Death (ED) was defined as death within the first 6 weeks (42 days) of treatment. Early Death was subdivided into two types : ED1 death within the first 15 days of induction 1 and reflects lethal envents due to leukastasis and bleeding. ED2 death within in the period between days 16 and 42 of induction I and reflects deaths caused by complications from infections and bleeding during aplasia after induction I therapy. The treatement-related mortality (TRM) was evaluated based on all patients with complete remission who died after day 28. The analysis of data was done by SPSS 18.0 Résultats : In all323 patients with de novo AML treated betwen 2011-2015, there were 115 (35.60%) deaths. In death group median age was 41 (18-60years) ; sex ratio H/F was 1.16 ; median hemoglobin was 7.38 g/dl (3.1-14.9) ; median platelet was 63.42 G/L (2.25-165) ; median leucocyte was 39.02 G/L (0.97-245) ; 33(28.69%) had hyperleukocytosis ≥50G/L ; for cytology, according to FAB the dominants types was M1 : 42 (36.5%), M2 : 30 (26.08%) , M4 : 17(14.78%) ; according to karyotype 13 (11.3%) had good prognosis ; 86(74.77%) was in intermediate group, 16(13.91%) had adverse prognosis. The death rate after two inductions was 30.34% and the treatement-related mortality was 17.39%.The death rate wich was 27 / year during 2011-2013 decreased to 17 / year between 2014-2015. The analysis of differents deaths is summarized in the table. Conclusion : Comparing the two periodsthe treatement-related mortality decreased but could be reduced by continue hygien education and improvement of supportive care therapy. Disclosures No relevant conflicts of interest to declare.

Introduction Treatment of AML in developing countries is a very great challenge. In Morocco, the major causes of therapy failure are delay in diagnosis, early (prior to start of therapy) and induction deaths, induction failures and abandonment of therapy. In 2011, the national AML-MA-2011 protocol was initiated to treat AML patients according to international standards and was focused on the improvement of supportive care with particular the prevention and management of infection, transfusion support, the patient, family and nurses education on hygien. The objective of this new protocol was to obtained more than 70% of complete remission, deaths in inductions less than 10%, and EFS at 4years at 40%. The aim of this study is to evaluate the results in adults AML patients treated with AML MA 2011 protocol in Casablanca Hematology Departement. Patients and Methods : Were reviewed the data ofpatients (aged 18-60yrs) treated according to AML-MA-2011 protocol from 1st january 2011 to 31th december 2015. Patients with APL or secondary AML were excluded. AML was diagnosed by studying peripheral blood smears, bone marrow aspiration, and biopsy slides stained with May-Grünwald Giemsa and myeloperoxidase. Immunophenotypic and cytogenetic studies were performed at diagnosis on bone marrow samples. AML was defined as the presence of more than 20% of myeloblasts in the bone marrow. Subtype of AML was recorded according to French-American-British (FAB) classification. Karyotype was performed on marrow sample, R banding technique was used. WHO 2008 prognostic classification was adopted. Patients with hyperleukocytosis (WBC≥ 50G/L) received as a pre-phase 4 days of hydroxyurea to 50mg/kg/day. The two courses of induction associated Cytarabine (100mg/m² q 12h (day 1-10)), Daunorubicin (50 mg/m² (day 2, 4, 6) for the first course, on days 1, 3, 5 for the second course) and etoposide (100mg/m² only at second course of induction). The consolidation included Cytarabine (3g/m² q 12h (day1-3) for first and second course and 1 g/m² (day1-3) on third course) plus Daunorubicin (30mg/m² (day 3-4 and day 1-3) at the first and third consolidation. L-Asparaginase 6000UI/m² on day 4 was give at second consolidation. Patients received CNS prophylaxis. Platelet support was provided in the case of bleeding, or whenever the platelet count was less than 10 × 109/L. For infections, Ceftazidime was the first line of antibiotic used. Amikacin was added for persistent fever beyomd 48-h or clinical deterioration. Imipenem was used for persistent fever. Additional antibiotic or antifungal or antiviral was dictated by clinical and biological findings. Complete remission (CR) was defined as the absence of abnormal clinical symptoms and having less than 5% of myeloblasts in the bone marrow, absence of blasts with Auer rods; absence of extramedullary disease; absolute neutrophil count >1.0 × 109/L; platelet count >75 × 109/L; independence of red cell transfusions. The analysis of data was done by SPSS 18.0 Résultats : 559 adults patients were diagnosed for AML,323 was treated by AML-MA-2011 protocol from 2011-2015. The median age was 38 years (18-60), the sex ratio M/F was 1.10 ; the median hemoglobin (g/dl) was 7.15 (2.6-16.3) ; the median platelet (G/L) was 38.5 (1-620) ; the median leukocyte (G/L) was 17.97 (0.85-377). For cytology, according to FAB the dominants types was M1 : 98 (30.34%), M2 : 97 (30.03%), M4 : 51(15.78%). 249 (77.08%) patients had immunophenotyping. According to karyotype, 46 (14.24%) had good prognosis ; 216 (66.87%) was in intermediate group, 61 (18.88%) had adverse prognosis. Complete remission after two inductions was obtained with 197(60.99%) patients, inductions failure was noticed on 49(15.17%) patients, 98(30.34%) patients died during inductions cycles ; 152(47.05%) achieved the second consolidation cycles, 66 (33.50%) patients whose were in complete remission relapse. The OS at 3-years was estimated at 48.4%. The analysis of therapeutics results is summarized in the table. Conclusion : The therapeutics results of AML-MA-2011 protocol in the treatement of adults AML patients are satisfactory but could be improved with reduction of infection toxic deaths and improvement of supportive care therapy. Disclosures No relevant conflicts of interest to declare.

To identify cooperating lesions in core-binding factor acute myeloid leukemia, we performed single-nucleotide polymorphism-array analysis on 300 diagnostic and 41 relapse adult and pediatric leukemia samples. We identified a mean of 1.28 copy number alterations per case at diagnosis in both patient populations. Recurrent minimally deleted regions (MDRs) were identified at 7q36.1 (7.7%), 9q21.32 (5%), 11p13 (2.3%), and 17q11.2 (2%). Approximately one-half of the 7q deletions were detectable only by single-nucleotide polymorphism-array analysis because of their limited size. Sequence analysis of MLL3, contained within the 7q36.1 MDR, in 46 diagnostic samples revealed one truncating mutation in a leukemia lacking a 7q deletion. Recurrent focal gains were identified at 8q24.21 (4.7%) and 11q25 (1.7%), both containing a single noncoding RNA. Recurrent regions of copy-neutral loss-of-heterozygosity were identified at 1p (1%), 4q (0.7%), and 19p (0.7%), with known mutated cancer genes present in the minimally altered region of 1p (NRAS) and 4q (TET2). Analysis of relapse samples identified recurrent MDRs at 3q13.31 (12.2%), 5q (4.9%), and 17p (4.9%), with the 3q13.31 region containing only LSAMP, a putative tumor suppressor. Determining the role of these lesions in leukemogenesis and drug resistance should provide important insights into core-binding factor acute myeloid leukemia.

Introduction: The outcome of acute myeloid leukaemia (AML) in emerging countries is very dismal. In Morocco,the complete remission rate (CR) has improved from less of 10% in 1980s to more than 60% in 2000s. However this improvement is far from satisfactory to improve five year survival rate. The aim of study was to evaluate preliminary outcomes of children ≤15years treated according to AML- MA 11protocol. Methods : Between the first January 2011 to December 2014, we carrieed a prospective study of all children aged 15 years or less, diagnosed AML. The diagnosis was according by cytological study with cytochemestry: MPO positive (FAB classification), supplemented by immunophenotyping. The prognosis is evaluated by conventional cytogenetic study. AML-MA 2011 protocol consisted of prephase(whenwhite blood cell (WBC) count ≥ 50 G/l) by Hydroxyurea (HU) (50 mg/m2/day for 4 days). The response to HU was evaluated after 2 days; patients were considered responsers if >50% reduction of the initial WBC count. Then 2 inductions based on daunorubicin 50 mg/m2 (3 days), cytarabine 100mg/m2/12 hours (10 days) and etoposide 100 mg/m2 (5 days) for the second course, followed by 3 consolidations with high dose of cytarabine 1-3 g/m2/12 hours (3 days), with intrathecal therapy. The supportive care is assured during all phases of treatment. Results: Forty four patients were enrolled with a median age of 8 years [1-15] and M:F ratio of 1.2. The median WBC count was 22710 elements/mm3; it exceeded 50 000/mm3 in 18 % of cases, more than 100 000/mm3 in 13 % of cases.The cytological studies showed the predominance of AML subtype 2 (31%) followed by subtype 5 (11, 3%). The immunophenotyping was done in 88% of cases. Karyotype performed in 40 out of 44 cases revealed: 9 (22,5%) favorable risk group [8 had the t(8,21); 1 had inv16], 25 (62,5%) intermediate risk, and 6 (15%) unfavorable-risk group. Seven patients received hydroxy urea with 5 good response (71% of cases; 2 patients had favorable risk and 3 had intermediate risk). Four of this patients died. Thirty five patients were treated (3 death before treatment, 4 abandonment of treatment, 1 myelodysplasea syndroma, and 1 bad condition). After the induction cycles; complete remission was achieved in 22 cases (62%), failure in 6 cases, and 7 children dead (20%) [4 septic choc, 2 haemorrhage and 1 acute pulmonary edema]. One patient died between 0 to 14 days during the cure and 6 others after 14 days of treatment. After a mean follow-up of 9months (1 to 43 months), continuous complete remission was achieved in 45,7% of cases, failure in 20%, relapse in 11%, and death in 45,45 % of cases. (toxic death in 25% of cases with high frequence in induction phases: 88%). Theoverall survival rate in 2 years was 41,2%. Table. Evolution of patients according to prognostic groups Status/cytogenetic groups CR (%) Failure (%) Death (%) Relapse (%) OS (%) favorable 55 0 11 22 53,3 intermediate 32 32 16 4 34,4 unfavorable 33 16 16 16 55,6 Conclusion: With aggressive chemotherapy, it is feasible to achieve high CR even in emerging countries. If supportive care is optimal with particular focus on prevention and management of infection and with improved transfusion support, then it's feasible to improve the overall outcome of patients. Finally it is necessary to make the molecular biology in our patients topreciselyindividualize the pronostic groups. Disclosures No relevant conflicts of interest to declare.

Introduction: Treatment of Acute Myeloid Leukemia (AML) with in developing countries is challenging. In Morocco, the major causes of therapy failure are delay in diagnosis, early (prior to start of therapy) and induction deaths, induction failures and abandonment of therapy. Improvement of supportive care with particular focus on prevention and management of infection and improved transfusion support is crucial for better overall outcome. Aim of the study: To evaluate the preliminary results (Complete remission, OS and EFS) in children and young adults with favorable risk group AML treated in a single center with AML MA 2011 protocol. Patients and methods: From January 2011 to December 2014, a uniform treatment protocol was conducted to treat patients with age ≤ 30 years with de novo AML with favorable risk group. The diagnosis was done according to FAB classification, MPO done systematically. Karyotype was performed on marrow sample (20 metaphases analyze at least), R banding technique. Patients with hyperleukocytosis (WBC≥ 50G/L) received as a pre-phase 4 days of hydroxyurea to 50mg/kg/day then 2 inductions and 3 consolidations. The two courses of induction associated Cytarabine (100mg/m² q 12h (day 1-10)), Daunorubicin (50 mg/m² (day 2, 4, 6) for the first course, on days 1, 3, 5 for the second course) and etoposide (100mg/m² only at second course of induction). The consolidation included Cytarabine (3g/m²q 12h (day1-3) for first and second course and 1 g/m² (day1-3) on third course) plus Daunorubicin (30mg/m² (day 3-4 and day 1-3) at the first and third consolidation. L-Asparaginase 6000UI/m² on day 4 was give at second consolidation. Patients received CNS prophylaxis. The supportive care consisted of transfusion, antibiotic and patient and family education by hygiene team. Results: 39/159 patients (24.5%) had a favorable prognosis. They were 13 female and 26 male (Male/Female ratio of 2) with a median age of 21 years and the peak frequency was between 20-30 years (21 patients or 53.8%). Two groups were identified. (Table 1) The means WBC were 39.741 G/L (1.134-425.000G/L) and more than 50 G/L for 17 patients. t(8; 21) represented 71.8% of karyotype and was associated 14 times with other abnormalities: 8 loss of sex chromosome (6 -Y and -X 2), 2 deletions, 2 trisomy and 2 add. Inv16 or t (16; 16), 28.2% of case, was associated with a deletion once and once with trisomy. (Table 1) Molecular biology carried 7 times was positive in 4 cases all AML-ETO. Three patients died before treatment, two in hospital by septic shock (1), subarachnoid hemorrhage (1) and one at home. 36/39 patients were evaluable for the protocol. 17 patients with WBC > 50G/L received hydroxyurea prior to chemotherapy with good response for 16 (94.1%) and 1 (5.9%) death. The median average time from start of treatment was 15 days with a range of 1-52 days. After the two inductions 26 (74.3%) obtained a complete remission, 2 (5.7%) were in failure, and 7 (20%) died in hospitalization during induction 1. The cause of death was: 2 hemorrhage, 3 infections, 1 pulmonary embolism and 1 patient died at home. Conclusion: Therapeutic results are yet far from satisfactory. Complete remission could be improved with reduction of infection toxic deaths. Improvement of supportive care therapy may allow treating patients with intensified treatment with better outcome. Hydroxyurea is efficient to reduce WBC and for best conditions to initiate induction therapy. Table 1. Patient's characteristics All patients Group 1(age ≤15years) Group 2(age≥16 years) Number (%) Median age (Years) 39 (100%) 21 9 (23%) 10 30 (77%) 24 Male/Female 2 3.5 1.7 WBC>50000 (G/L) 17 2 7 FAB M1/M2/M4/M4Eo/other Immunophenotype 12/19/2/4/2 28 (71.8%) 1/7/1/0/0 7 (25%) 11/12/1/4/2 21 (75%) t(8 ;21) 28 (71.8%) 8 (88.9%) 20(66.7%) t(8 ;21)+ other anomalies 14 (50%) 5 (62.5%) 9 (45%) Inv 16 or t(16 ;16)Inv16 or t(16 ;16) + other anomaliesTreatmentComplete remission DeathFailureCauses of death infection/Hemorrhage/otherOSES 11 (28.2%) 2 (18.2%) 36*(92.3%) 26 (72.2%) 7 (18%) 2 2/3/2 51% 30.9% 1 (11.1%) 1 (100%) 9 (100%) 8 (88.9%) 1 (11.1%) 0 0/1/0 10 (33.3%) 1 (10%) 26 (86.7%) 18 (69.2%) 6 (23.1%) 2 (7.7%) 2/2/2 *One death after prephase Disclosures No relevant conflicts of interest to declare.