# Cystic echinococcosis in patients with leukemia: Clinical challenges and review of reported cases

## TL;DR

This paper presents two rare cases of a parasitic infection in leukemia patients from Peru and discusses the challenges of treating both conditions simultaneously.

## Contribution

The paper reports the first documented cases of cystic echinococcosis in leukemia patients from Latin America.

## Key findings

- Albendazole can be safely used with chemotherapy without significant liver toxicity in these patients.
- Treatment strategies must be tailored based on leukemia type and patient stability.
- Cases from Latin America are underrepresented in the literature on this co-occurring condition.

## Abstract

•Two rare cases of cystic echinococcosis in patients with leukemia.•Reports are scarce, and cases from Latin America appear to be underrepresented.•Albendazole was administered with chemotherapy without clinically significant hepatic toxicity.•Antiparasitic and oncologic treatment depended on leukemia type and the patient’s stability.•Individualized approaches to parasitic infections in immunocompromised hosts.

Two rare cases of cystic echinococcosis in patients with leukemia.

Reports are scarce, and cases from Latin America appear to be underrepresented.

Albendazole was administered with chemotherapy without clinically significant hepatic toxicity.

Antiparasitic and oncologic treatment depended on leukemia type and the patient’s stability.

Individualized approaches to parasitic infections in immunocompromised hosts.

Cystic echinococcosis (CE) rarely coexists with hematologic malignancies. We report two Peruvian men with leukemia and CE.

One patient had chronic lymphocytic leukemia and a hepatic CE2 cyst managed with albendazole and surgery before chemoimmunotherapy, and another patient had B-cell acute lymphoblastic leukemia and prior hepatic and pulmonary CE treated with concurrent albendazole and induction chemotherapy. Both patients lived in endemic highland areas and had childhood exposure to dogs.

A literature review identified only a few cases, mostly acute myeloid leukemia, and none from Latin America.

These cases highlight therapeutic dilemmas in balancing infection control and malignancy treatment, underscoring the need for tailored management strategies in endemic regions.