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Patients with acute leukemia have been shown to have elevated serum iron levels and markedly diminished or absent unbound iron binding capacity (21 of 34 patients with myeloblastic and 2 of 6 patients with lymphoblastic leukemia). Four patients (2 myeloblastic and 2 lymphoblastic) developed systemic candidiasis with elevated Candida agglutination titers and positive precipitin tests against a somatic antigen of Candida albicans. It is postulated that high serum iron and/or low unbound transferrin predispose patients with acute leukemia to candidal infection by enhancing growth of this fungus. In vitro studies support this hypothesis.