{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:03:17Z","timestamp":1779771797740,"version":"3.53.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":144,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>A 7\u2010month\u2010old infant developed therapy\u2010independent acute lymphoblastic leukemia (ALL) 8\u2009months after complete resection of an International Neuroblastoma Risk Group (INRG) Stage L1 adrenal neuroblastoma (N\u2010MYC nonamplified) treated with surgery alone. The patient presented with leukemia cutis and discordant bone marrow findings: the initial aspirate revealed &gt;\u200990% lymphoblasts (CD45+\/CD19+\/CD10+\/TdT+), whereas two subsequent marrow examinations showed normocellular hematopoiesis, suggesting spatially heterogeneous marrow involvement with predominant extramedullary disease. Skin biopsy confirmed leukemic infiltration (PAX5+\/TdT+\/CD34+\/CD10\u2212). Germline testing was not available. Standard\u2010risk chemotherapy achieved complete remission, and the patient is currently receiving maintenance therapy. This case highlights that second primary ALL can occur in the absence of cytotoxic therapy after neuroblastoma and underscores the need for long\u2010term surveillance and consideration of genetic evaluation in selected patients.<\/jats:p>","DOI":"10.1155\/crh\/5543785","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:21:24Z","timestamp":1779769284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metachronous B\u2010Cell Acute Lymphoblastic Leukemia After Localized Neuroblastoma Treated Without Cytotoxic Therapy: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3663-7391","authenticated-orcid":false,"given":"Reihaneh","family":"Sedghi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4392-9313","authenticated-orcid":false,"given":"Ahmad","family":"Nazar Zadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8071-6425","authenticated-orcid":false,"given":"Mohammadreza","family":"Bordbar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-3198","authenticated-orcid":false,"given":"Omid Reza","family":"Zekavat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-9807","authenticated-orcid":false,"given":"Shirin","family":"Parand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25249"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.626018"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-023-04477-0"},{"key":"e_1_2_15_4_2","volume-title":"Lanzkowsky\u2019s Manual of Pediatric Hematology and Oncology","author":"Lanzkowsky P. 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