Acute lymphoblastic leukemia in persons over the age of 30 yr in the middle east.

In his letter, Vazin1 has described 10 yr of experience with the morphological diagnosis of acute leukemia (AL) in Iran. He reports no patient with acute lymphoblastic leukemia (ALL) over the age of 30 and makes a statement that this type of leukemia does not occur in this age group. He is probably referring to Iran only, for I have a different experience in Iraq, Iran’s neighbor to the west. In the first 18 mo of hematology practice at the University of Baghdad Medical Center I have taken care of 39 newly diagnosed adults (15 71 yr of age) with AL, I I of whom had ALL. Three of the latter group were over the age of 30. The diagnosis was made in all patients by morphological criteria,2 and was confirmed in two of these three patients with a positive periodic acid Schifl (PAS) stain. The third patient was a 43-yr-old man initially diagnosed as having acute myelogeneous leukemia. He failed to respond to three courses of cytosine arahinoside and daunorubicin. The diagnosis was later changed to ALL when a new and the