Three consecutive patients with acute promyelocytic leukaemia who presented with severe haemorrhagic syndromes were studied and the findings contrasted with those of two patients with classical defibrination after electroshock or complicated labour. The leukaemic patients showed no depletion of fibrinogen. There was no evidence of disordered thrombin generation by either intrinsic or extrinsic pathway sufficient to account for their haemorrhage. All, however, showed strikingly enhanced fibrinolytic activity, which could have accounted for bleeding. This fibrinolytic disorder was characterized by free u-PA in the plasma and differed from that seen after classical defibrination, where free t-PA was observed. U-PA was found also in malignant promyelocytes, which may be the source of u-PA activity in the patients' plasma. Bleeding in promyelocytic leukaemia may be primarily a fibrinolytic disorder.

Sixty‐three patients with Hodgkin's disease and non‐Hodgkin's lymphoma were followed up for exactly 5 years after first diagnosis. Survival analysis was carried out using the log‐rank test (univariate) and Cox's proportional hazards regression method (multivariate). Variables examined were: age at diagnosis; gender; stage; symptoms; type of disease; grade of tumour, performance status; presence or absence of hypnotherapy or relaxation training; Eysenck Personality Inventory L‐scores; and Hospital Anxiety and Depression Scale scores. At diagnosis, in keeping with previous studies, L‐scores were high. Although L‐scores can be raised for several reasons, the L‐scale may be a useful measure of the cancer‐prone (type C) personality. Moreover, as predicted, L‐scores were associated with an increased risk of death within 5 years; L‐scores emerged as an independent risk factor as did depression scores. A relaxation‐based intervention may also have enhanced survival. Replication in the lymphomas, and investigation in other cancers, should be carried out.

Young women with a chemotherapy-induced early menopause are theoretically at considerable risk of developing post-menopausal osteoporosis with problems developing earlier and more severely. In this study bone mineral density (BMD) measurements were made, using a dual-energy X-ray absorptiometer (DXA), at the spine and hip of 50 young women who had been treated for lymphoma, 24 of whom were post-menopausal and 78, healthy age-matched controls. On analysis of the results, there was no significant difference between the control group and the 26 post-treatment, pre-menopausal patients, but the BMD levels were significantly lower than the controls in the post-menopausal group particularly in 16 patients who had been menopausal greater than 18 months. The results confirm that these young women with treatment-induced premature menopause are at considerable risk of developing osteoporotic problems. Early recognition of this is important so that preventative measures with hormone replacement therapy can be initiated where this is safely possible. The results also indicate that chemotherapy for lymphoma (cytotoxics and high dose intermittent steroids), are unlikely to contribute directly to the lowering of the BMD of these patients.

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