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Three patients with M2 acute myeloid leukemia (AML) in whom cord compression developed due to epidural granulocytic sarcoma are reported and compared with six similar patients described previously. These three cases had 8;21 translocation, t (8;21), in the marrow karyotype and also in the karyotype of granulocytic sarcoma tissue obtained from two of the cases. Treatment with chemotherapy and radiotherapy can be effective, but an emergency laminectomy should be performed if there is rapid neurologic progression.

The gastroduodenal mucosa has a rich blood supply. An

The availability of monoclonal antisera against specific determinants present on T lymphocytes45 has provided a reliable method for investigating T cell populations in immunological disorders. Of these antibodies, Leu-4 reacts with all peripheral T lymphocytes, Leu-12 reacts with all B lymphocytes, OKT4 with the helper/inducer population, and OKT8 with cytotoxic/suppressor cells. We have investigated the ratio of the OKT4 to OKT8 positive lymphocytes in patients with megaloblastic anaemia who responded to hydroxocobalamin injections. Material and methods SELECTION OF PATIENTSPatients who were in remission from megaloblastic anaemia responsive to injections of hydroxocobalamin were studied. Each patient had a documented macrocytic anaemia which had responded to hydroxocobalamin alone; patients who had received folic acid or iron treatment before a clear response to hydroxocobalamin were excluded from the study. All patients were receiving maintenance hyd-

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To define further the clinical importance of cytogenetic analysis in acute lymphoblastic leukaemia (ALL) a prospective study was performed on 139 unselected children. Analyses were considered adequate in 104, of whom 35 were normal and 69 had clonal abnormalities. Abnormalities were categorised according to banded chromosome analysis as well as chromosome count. Karyotypes were correlated with clinical and laboratory features at diagnosis and with survival. Of the successful analyses, thirty five (34%) children had no abnormalities; this group contained an excess of T cell disease. Twenty five (24%) had a "characteristic" hyperdiploid karyotype and as a group had lower presenting white counts, a tendency to CD1O, and periodic acid schiff positivity of the blast cells and smaller spleens. None was an infant and only one was over 10 years old. Seven (7%) children with t(9; 22), t(8; 14), or t(4; 11) translocations were grouped together as "specific" translocations. Collectively they had a significantly worse prognosis than the remainder. Nine children developed central nervous system relapse, six of whom had either t(4; 11) or abnormalities of 9p or l9p.A descriptive classification taking into account chromosome bonding pattern is cytogenetically more appropriate and may be more clinically useful than grouping children simply by chromosome number. As knowledge and techniques improve, the classification of cytogenetic abnormalities in ALL will need to be kept under frequent review.

Summary:We describe a case of severe autoimmune haemolytic anaemia developing in newly diagnosed ulcerative colitis of moderate severity. Full inmunosuppression with steroids and azathioprine failed to bring about a full remission and a splenectomy was performed which resulted in a remission enabling immunosuppression to be discontinued. This case is compared with three previously described cases of autoimmune haemolytic anaemia associated with severe colitis requiring splenectomy.