Two cases of acute lymphoblastic leukemia with eosinophilia are described. The degree of eosinophilia was such that at presentation, a provisional diagnosis of eosinophilic leukemia was made. Cytogenetic evidence is presented, indicating that the eosinophilia is reactive to the leukemic process rather than part of it. A mechanism for the production of the eosinophilia is discussed, and it is suggested, on the basis of our findings, that acute eosinophilic leukemia may be of rarer occurrence than is already accepted.

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