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Concerning response to treatment and overall prognosis, all patients experienced a complete response to induction therapy with rapid decrease in leukocytosis and resolution of extramedullary involvement under corticosteroid therapy. MRD, when applicable, was found negative at the end of induction, underlying high sensitivity to chemotherapy. This high chemosensitivity contrasted with the high incidence of relapse (occurring in three of our cases) and poor overall prognosis. This finding underlines the importance of quick identification of this rearrangement to propose treatment adaptation to high-risk groups, including allogeneic marrow transplantation consideration before facing potentially chemoresistant relapse.In summary, we describe here five cases of mature 'sIg þ ' B-ALL with non FAB-L3 morphology displaying 11q23-MLL rearrangement, and especially t(9;11), occurring in young children with a poor prognosis and requiring treatment intensification.

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Left ventricular (LV) intramyocardial markers (MM) were used to study the effects of intravenous verapamil on LV pump function and diastolic filling dynamics. Verapamil (0.1 mg/kg bolus followed by 0.005 mg/kg/min) was administered to 10 patients with severe coronary artery disease 4 years after coronary bypass grafting and implantation of 7 tantalum markers into the LV. MM were filmed at 100 frames/sec (biplane 30 degrees RAO/60 degrees LAO). The digitized biplane MM coordinates were transformed into 3-dimensional coordinates and maximal projection area was defined. LV volumes were calculated frame-by-frame and ejection fraction and peak filling rate derived. Pressure-volume relations were calculated in early-, mid-, and end-diastole. Verapamil caused a slight rise in end-diastolic pressure (12 to 14 mmHg, p less than 0.001) and end-diastolic volume (142 to 152 ml; p less than 0.005) and a fall in max dP/dt (1732 to 1570 mmHg/s; p less than 0.01) reflecting the drug's negative inotropic action. Verapamil reduced LV systolic pressure (136 to 126 mmHg; p less than 0.01), diastolic aortic pressure (74 to 68 mmHg; p less than 0.001) and peripheral resistance (1496 to 1348 dynes.s.cm-5; p less than 0.025); cardiac index was increased (2.7 to 2.9 l/min/m2; p less than 0.05), as were ejection fraction (47 to 49%; p less than 0.02) and stroke volume (67 to 75 ml; p less than 0.001). Great cardiac vein flow increased as well (88 to 102 ml/min; p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)