James A. Wolff

EFFECTS OF ENVIRONMENTAL CHEMICALS ON THE METABOLISM OF DRUGS, CARCINOGENS, AND NORMAL BODY CONSTITUENTS IN MAN

A. H. Conney, Ph.D.,* R. Welch, Ph.D.,* R.Kuntzman,Ph.D.,*t R. Chang, M.S.,*

Epidemiological factors and survival experience in 1770 children with acute leukemia. Treated by members of Children's Study Group A between 1957 and 1964.

M. Jacobson, M.S.,*t A. D. Munro-Faure, M.A.,

Wiskott-Aldrich syndrome: clinical, immunologic, and pathologic observations.

A. W.Peck,M.B.,

Predinsome therapy of acute childhood leukemia: Prognosis and duration of response in 330 treated patients

A.Bye,B.S.,

Management of isoimmune neonatal thrombocytopenia

A.Poland,M.D.,llP. J. Poppers, M.D.,** M. Finster, M.D.,** and J.A. Wolff, M.D.** *The Wellcome Research Laboratories, Burroughs Wellcome and Co. (U.S.A.) Inc., Tuckahoe, N . Y .

Adjuvant chemotherapy of malignant fibrous histiocytoma of bone

The Wellcome Research Laboratories, Beckenham, Kent, England %The Rockefeller University, New York, N . Y . **The Departments of Anesthesiology and Pediatrics, College of Physicians and Surgeons, Columbia University, New York, N . Y .

First light on the horizon: The dawn of chemotherapy

In a group of 1770 children with acute leukemia, treated in 11 pediatric centers associated with Childrens Cancer Group A, surgical data was related to age at diagnosis, morphological type, the leukocyte count at onset, and the year of diagnosis. The age distribution was different in the 3 morphological types of childhood leukemia. A peak at the age 2 to 3 years, with a broad base extending from 2 to 5 years, was characteristic of acute lymphoid leukemia, while the peak was absent in other morphological types. The age distribution was similar in Caucasian and Negro children. The most favorable prognosis was found in children with acute lymphoid leukemia who were 2 to 6 years of age at diagnosis in whom the leukocyte counts were below 4,000/mm3 at onset. Progress in extending the median survival time of all children with acute lymphoid but not other types of leukemia was noted between 1957 and 1964. The 10% survival figure improved for all types of leukemia during this period.

MANAGEMENT OF THALASSEMIA: A COMPARATIVE PROGRAM

Clinical, immunologic, and pathologic observations in the Wiskott-Aldrich syndrome are reported. One of the eight subjects of this report, now 14 years of age, is the oldest known survivor. A number of striking abnormalities are described, including including deficiencies of isoagglutinins, immunoglobulin and lymphocytes in peripheral blood and tissues. The presence of thymic hypoplasia found at postmortem suggests that this defect may play a major role in the pathogenesis of the immunologic deficiencies in this syndrome. The detection of immunoglobulin deficiency may be valuable in identification of carriers and latent cases.

Radiation Therapy for Lymphoma in Children

Induction of remission with prednisone in 330 children with acute leukemia resulted in improvement to complete remission in 40 per cent and in good partial remission in another 34 per cent of patients. Complete bone marrow remission occurred in 63 per cent. Remission was maintained without treatment for a median duration of 58 days. Infants under 1 year of age, patients with initially high white blood cell counts, and those with a morphologic diagnosis of acute granulocytic leukemia responded less favorably than the other children.

Acute lymphocytic leukemia masquerading as acute osteomyelitis. A report of two cases.

Two infants, who presented at birth with isoimmune thrombocytopenic purpura, are the basis for this report. The problems confronting the physician in treating an affected infant, as well as in the management of subsequent pregnancies after an infant with isoimmunization has been delivered, are discussed. In view of the small but serious risk of intracranial hemorrhage during the birth process in these infants, delivery by cesarean section is advocated for all pregnancies known to be at risk i.e., after a previous infant has been shown to be affected.