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Case report
We present three children with precursor B acute lymphoblastic leukemia (ALL). The first one had malignancy associated hypercalcemia at diagnosis. The second one experienced hyperamonemia during induction. Both of them had been treated successfully. The last one had refractory leukemia and died because of lactic acidosis due to extensive infiltration of the liver by tumor cells. The rare but potential fatal metabolic complications of ALL needs high clinical suspicion and prompt treatment.
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