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A 6 month old boy with severe combined immunodeficiency disease was treated successfully with a bone marrow 'ranspiantaiion (BMT) from his HLA-icntical dizyqotic female twin. Development of immune functions was achieved within 3 months with full reconstilulion of T-and B-lympnocyfc-mcdiated responses. The donor was Iransfused with irradiated self fresh whole blood, she showed good tolerance for the procedure, without complications and was discharged 24 hours later without changes in her hematological parameteis. The receptor showed clinical and bacteriological evidences of disseminated infection by bacillus of CalmeUe-Guerin before and after bone marrow transplantation, and was treated with rifanpicine, isoniazid, ethambutol. The clinical pre.sentclion of BCG infection was like that seen in similar cases and mimiked some aspects of local reactions at BCG vaccination site that have been described in patients with Kawasaki disease. No conditioning treatment was given to ihe patient and a mild graft versus host disease was seen one month after bone marrow infusion, consisting of rash, hepatomegaly, thrombocytopenia and increased scrum activity of liver enzymes. He was successfully treated with hydrocortisone and prcdnisonc for three months. One year after bone marrow trnsplantation the patient remains clinically well and free of any significant infection.

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Thirty nine pcdiolric patients with chronic idiopathic thrombocytopenic purpura have been followed by the same medical team of a university associated children's hospital from Santiago, Chile, for a total of 25 years. Pat'enrs were treated with a slep by stop protocol lhat included observation, prcdnisone, splenectomy and immunosuppressors. Twenty ihrcc palients [59%) eventually recovered. 48% did it spontaneously, 17% afler prednisone treatment, 3"% alter splenectorny and 4% after all precedent methods and immunosuppressor drugs trealment. The therapeutical decissions were always taken depending on the clinical evolution and nol after prestablished time schedules.(