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

• Two rare cases of cystic echinococcosis in patients with leukemia. • Report are scarce, and cases from Latin America appear to be underrepresented. • Albendazole was administered with chemotherapy without clinically hepatic toxicity. • Antiparasitic and oncologic treatment depended on leukemia and 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 with chronic lymphocytic leukemia (CLL) and a hepatic CE2 cyst managed with albendazole and surgery before chemoimmunotherapy, and another with B-cell acute lymphoblastic leukemia (B-ALL) 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.