Sir.—We read with interest the article "Second Malignancy in Acute Lymphocytic Leukemia: Review of 33 Cases" by Drs Mosijczuk and Ruymann in the Journal (1981;135:313-316). In the article the authors state, referring to four patients in whom chronic myelogenous leukemia (CML) developed after treatment of acute lymphocytic leukemia (ALL), that no patients had cytogenetic studies performed at the time of the initial diagnosis of ALL. We wish to point out that in a previous study,1 quoted by Drs Mosijczuk and Ruymann, we did describe the cytogenetic data at the time of the occurrence of ALL in one of the patients (patient 4) the authors referred to. The karyotype of that initial marrow, as well as six subsequent consecutive remission marrows, were normal. The cytogenetic aspect on this patient was also separately published together with chromosome data from another two patients with juvenile CML.2 Unlike adult-type CML with
INOUE S, RAVINDRANATH Y, LUSHER JM. Second Malignancy in Acute Lymphocytic Leukemia. Am J Dis Child. 1982;136(2):175–176. doi:10.1001/archpedi.1982.03970380087024
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