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to 50.000 cells/µL. The examined peripheral blood smear appeared as similar to the chronic phase of CML (fig.2). A cytogenetic examination of Philadel phia chromosome [t(9:22] was found to be negative, therefore, CML was excluded in the patient. Hydroxurea was initiated once a day. Leukocytosis recovered to normal range after one week (fig.3) and bone marrow examination revealed remission. Cytogenetic analysis was normal and this leukocytosis was determined as reactive leukemoid reaction. We aimed to report this case owing to the fact that leukocytosis associated with G-CSF, which is used to increase the leukocyte count during neutropenia, has been reported previously but it occurred after second chemotherapy without G-CSF [4]. We know that this condition is a very rare situation.

Leukemoid reaction in a patient with acute lymphoblastic leukemia following the second chemotherapy