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Abstract  We report a case of Mediterranean visceral leishmaniasis (MVL) associated with acute lymphoblastic leukemia (ALL) from the South of Iran. The patient, a 12-year-old girl, was known to be a case of ALL and had bone pain and prolonged fever on referral. A trephine biopsy revealed a hypocellular marrow with many amastigotes. Moreover, by specific polymerase chain reaction (PCR) on peripheral blood, a 145 bp band corresponding to kDNA from the genus Leishmania was detected and the species was identified as Leishmania infantum using nested PCR. The patient was treated successfully with two courses of amphotericin B plus IFN-γ. To our knowledge this is first report of MVL/ALL from Iran and possibly the world. [ABSTRACT FROM AUTHOR]