This report presents an account of fatal hemolytic disease of the newborn (HDN) due to anti-D in a mother whose red cells showed the phenotypic characteristics of Rh positive Du variant. The proposita's third pregnancy was uneventful until the eighth month, when she presented with an unusually large abdomen. A sonogram showed fetal hydrops, and amniocentesis yielded a delta OD450 reading in Zone 3. Anti-D with a titer of 4096 was identified in the mother's serum. Following delivery by cesarean section, the premature infant did not respond to resuscitation. The autopsy findings were consistent with Rh erythroblastosis fetalis. The proposita has been classified as a Category VI Du variant with anti-D in her serum.
Twenty‐seven children with Hodgkin's disease were treated with MVOPP (mustine, Velban [vinblastine], Oncovin [vincristine], procarbazine, prednisone) combination chemotherapy. All II children with Stage I or Stage II disease achieved complete remission and no relapses have occurred between 34 and 179 months of continuous follow‐up. Of the 16 children with Stage III or Stage IV disease, two with partial remission and three nonresponding patients died with a median survival of 18 months. The remaining II (68%) achieved complete remission. Of these, 6 (55%) have relapsed with a median remission duration of 36 months; five have been retreated with MVOPP, and one with total nodal irradiation, and all achieved second complete remission. Three of the children have died of Hodgkin's disease, with a median survival of 55 months; one child died of acute myeloblastic leukemia while in remission; and one child remains disease‐free off all therapy at 165 months; the sixth child treated with total nodal irradiation is disease‐free at 166 months. The initial complete remission has been sustained in all II children with Stage I or Stage II Hodgkin's disease, suggesting that combination chemotherapy is an alternative to radiotherapy as the initial form of treatment in this group of individuals.
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