108 consecutive patients with de novo acute myeloid leukaemia at ages 15 to 59 years were treated in a prospective controlled multicentre trial. Induction with combination TAD resulted in a complete remission in 85 cases (79%). After a cyclic consolidation programme for 6 months, 73% of the remissions continued. The maintenance therapy was at random either nothing, or alpha interferon, or monthly 5 day courses with thioguanine and cytarabine. The median duration of all remissions was 13 months; that of those in the control and interferon arms 15 months each, and in the chemotherapy arm 18 months. The median survival of all the 108 patients was 16 months; that of those in the control arm 20 months, in the interferon arm 33 months and in the chemotherapy arm 26 months. At 5 yr, 31%, 22% and 31%, respectively, were alive. The survival curves did not differ from each other significantly. Maintenance treatment after an intensive induction and a moderately intensive consolidation was of no benefit in this study. Interferon did not improve the prognosis.

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A case of chronic lymphocytic leukemia (CLL) occurring simultaneously with Philadelphia chromosome-positive chronic granulocytic leukemia (CGL) in a 58-year-old man is described. The patient presented with typical CGL (all bone marrow mitoses having a Philadelphia chromosome), but during the course of busulfan therapy, CLL became more prominent, less than half of the bone marrow mitoses having a Philadelphia chromosome. The patient is in good clinical condition after a follow-up of 3.5 years, and the clinical picture resembles that of typical CLL.The coexistence of CGL and CLL here may be explained by chance alone. Evidently the histogenesis of t w o chronic leukemias in our patient took place as an independent evolution of two malignant hematopoietic clones. In spite of the frequent association of chronic leukemias with secondary cancer, no well-documented cases of two chronic leukemias with a simultaneous presentation have been described previously.

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