Confirmatory trials are needed, and the activity of gemcitabine in previously untreated patients should be assessed.

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2 patients with coexistent polycythaemia Vera and chronic lymphocytic leukaemia are described. A 61-year-old man presented with an increased packed cell volume (PCV) and a leucoerythroblastic blood picture, which was reversible upon treatment, neutrophil leucocytosis, bone marrow lymphocyte infiltration and splenomegaly, and subsequently developed lymphomas, blood lymphocytosis and thrombocytosis. The second case was a 58-year-old female presenting with increased PCV and leucocyte alkaline phosphatase score. She later had neutrophil leucocytosis, thrombocytosis, lymphocytosis, lymphomas and splenomegaly. These cases, together with 6 cases published by others, suggest that an association exists between the two diseases.

SummaryIn order to establish the optimal dose of tamoxifen in the treatment of advanced breast cancer in postmenopausal women, a randomized trial comparing 90 mg daily with the currently recommended dose of 30 mg daily was conducted. Sixty-eight patients were treated with the high dose and 75 patients with the low dose. The rate of response was 36 and 37~ (p = 0.74), respectively. The time to response, duration of response, and the time to treatment failure were also identical at the two dose levels. Only a few side effects were observed, and they were equally distributed among the two treatment groups. It is concluded that a 30 mg daily dose of tamoxifen seems to be as effective as 90 mg.

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