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Summary. Bone marrow graft rejection following HLA‐matched bone marrow transplantation (BMT) for leukaemia has been a rare problem. However, with the introduction of T‐lymphocyte depleted BMT, graft rejection is recognized as a new complication. At the Royal Free Hospital (RFH) in London T‐depletion is achieved using two monoclonal antibodies with complement mediated lysis. The methodology was extended to other centres and in total 56 patients have received T‐depleted, HLA matched BMT. Twelve of 56 patients have had graft rejection. At the RFH three of 41 (7%) patients have had rejection whereas at collaborating centres nine of 15 (60%) patients have had rejection. We have investigated these rejections in order to identify factor(s) responsible. Rejection was not restricted by patient or donor characteristics, nor disease status. Patient management, chemotherapy conditioning, efficiency of T‐depletion, graft versus host disease (GvHD), and infection post BMT, were not consistently implicated. The major difference between the RFH and all other centres was in the radiotherapy (RT) conditioning: The RFH prescribed a single fraction of 7‐5 Gy total body irradiation (TBI) whilst collaborating centres gave 10 or 12 Gy fractionated TBI. We conclude that the different incidence of rejection (7% v. 60%) relates primarily to the RT conditioning although the mechanisms(s) of rejection remain unknown. We conclude that where T‐depleted BMT is used, compensation by more intensive RT conditioning is required in order to avert graft rejection.

(1974). Thorax, 29,[553][554][555][556][557][558]. Carcinoid tumour of the thymus with systemic manifestations: a radiological and pathological study. Following recent reports of an unusual mediastinal tumour described as 'mediastinal endocrine neoplasm of probable thymic origin, related to carcinoid tumour' (Rosai and Higa, 1972), a further case, in a 72-yearold man, has been studied.Polyarthropathy was the presenting feature, and the patient also had clubbing of the fingers and clinical evidence of a probable proximal myopathy and a peripheral neuropathy. These non-metastatic systemic manifestations have not previously been described with this type of tumour.