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We fully agree with Dr Goldman and his associates that the incidence of AL in CLL is low, and we so stated in our original paper. However, we question their conclusion that "the lack of significant difference between the 19 reported and the 12 predicted cases of CLL with AL implies that the probability is high that the difference occurred by chance," since they are comparing apples with peaches.The death rates from CLL and AL cited by Goldman et al were obtained from a review of death certificates. On the other hand, the 20 (not 19) cases cited by Goldman et al from our paper represent those cases reported in the published literature only. We do not know how many more patients with CLL died of AL but were never reported. In addition, at least one more patient described in our paper was excluded from our analysis
Grünwald HW, Zarrabi MH, Rosner F. Statistical Approach to Chronic Lymphocytic Leukemia and Acute Leukemia-Reply. Arch Intern Med. 1978;138(4):659. doi:10.1001/archinte.1978.03630280103039