Summary. Disparity for the minor histocompatibility antigen HA-1 between patient and donor has been associated with an increased risk of acute graft-versus-host disease (GvHD) after allogeneic human leucocyte antigen (HLA)-identical sibling donor stem cell transplantation (SCT). However, no data concerning the impact of such disparity on chronic GvHD, relapse or overall survival are available. A retrospective multicentre study was performed on 215 HLA-A2-positive patients who received an HLA-identical sibling SCT, in order to determine the differences in acute and chronic GvHD incidence on the basis of the presence or absence of the HA-1 antigen mismatch. Disease-free survival and overall survival were also analysed. We detected 34 patient±donor pairs mismatched for HA-1 antigen (15´8%). Grades II±IV acute GvHD occurred in 51´6% of the HA-1-mismatched pairs compared with 37´1% of the non-mismatched. The multivariate logistic regression model showed statistical significance (P: 0´035, OR: 2´96, 95% CI: 1´07±8´14). No differences were observed between the two groups for grades III±IV acute GvHD, chronic GvHD, disease-free survival or overall survival. These results confirmed the association between HA-1 mismatch and risk of mild acute GvHD, but HA-1 mismatch was not associated with an increased incidence of chronic GvHD and did not affect relapse or overall survival.

We report four cases of Scedosporium inflatum (S. inflatum) infection in severely immunocompromised haematological patients. Six well-documented cases of S. inflatum disseminated infection in haematological patients have been reported: four in Australia and two in Spain. Their clinical and pathological characteristics are heterogenous, particularly in the Australian cases. However, the clinical and pathological profile emerging from our and other Spanish cases is homogenous and very similar to the clinico-pathological spectrum of other disseminated mycoses, including Aspergillus and S. apiospermum. The optimal treatment of S. inflatum infection is unknown and the outcome in haematological patients is very poor. Eight patients died despite systemic antifungal treatment.

In 1982 we began a prospective controlled trial to assess the effectiveness of allogeneic bone marrow transplantation and intensive post-remission cheniotherapy for patients with acute myelogenous leukaemia in first complete remission. Fourteen patients, 3 4 5 years of age, who had a n HLA-identical sibling donor, received bone marrow transplantation. Twenty-five patients who either lacked a n HLAidentical sibling or were over 4 5 years of age received intensive consolidation chemotherapy including high-dose cytosine arabinoside with or without adriamycin.The actuarial rate of continued complete remission (CCK) at 3 years was significantly higher in the transplantation group than in the chemotherapy group: 70'x (95% confidence interval 35-91%) compared with 10Vh (95% confidence interval 2-300/,): P = 0.01. However, the actuarial rate of CCK was not significantly different between the transplan-Correspondence: Dr E. Conde. Servicio de Hema tologia. Hospital Nacional 'Marques de Valdecilla'. 39008 Santander, Spain.

Summary:Lupus anticoagulant antibodies have never been reported to disappear after either allogeneic or autologous bone marrow transplantation in humans. We report the first case of disappearance of lupus anticoagulant antibodies in a patient without systemic lupus erythematosus or clinical evidence of other autoimmune disorders, who received an allogeneic bone marrow transplant as treatment for chronic myeloid leukemia. Although marrow transplantation is not a recognized therapy for antiphospholipid syndrome, our observation should be considered another example of the capability of intensive chemo-radiotherapy followed by stem cell transplantation to ablate a pathologic marrow clone resulting in an autoimmune disorder and improve, or even cure, some severe autoimmune diseases.