Aims: To document the features of the socalled aplastic presentation of childhood acute lymphoblastic leukaemia (ALL) and to determine whether this prodrome can be distinguished from aplasia.Methods: The peripheral blood and bone marrow appearances of all cases of childhood ALL presenting in one health region of England in 13 years and eight months were reviewed. All cases presenting with cytopenia without circulating blasts and marrow aspirates with no infiltrate of blasts were studied in detail.
Summary.-Thirty-two adults with acute myeloid leukaemia (AML) were randomized to receive, from the time of diagnosis, either chemotherapy alone (C group) or chemotherapy plus Bacille Calmette-Guerin vaccine (BCG) (C + I group). After remission induction and consolidation, chemotherapy was stopped in both groups but BCG was continued in the C + I group.The overall survival of the C + I group was significantly increased (P < 0-05). There was no significant increase in the duration of first remission in the C + I group (0 05
0.1) but reduction in survival after CNS relapse was highly significant (P=0 001). These results suggest that administration of BCG from an early stage in the treatment of AML may protect the CNS against leukaemic infiltration and therefore serve as a simple, innocuous form of CNS prophylaxis.
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