Significance of common acute lymphoblastic leukemia antigen (cALLA) positive cells in bone marrow of children off therapy in complete remission.

Bone marrows from 21 children with acute lymphoblastic leukemia in complete remission (CR) and off therapy for 14 months to 10 years were examined by flow cytometry with a panel of monoclonal antibodies. Significant percentages of cALLA+ cells of low fluorescence intensity were present up to 9 years after CR. These results emphasize the need to interpret flow cytometry results in light of the findings that low intensity cALLA+ cells represent a normal population of immature, non-malignant lymphoid cells.

Unexplained bleeding associated with central venous catheter care.

Significant bleeding associated with inadvertent heparin overdosage may occur in children with cancer and indwelling central venous catheters. The etiology of such bleeding, as described in a child with Wilms' tumor, may not be immediately apparent. It is imperative that the proper techniques for maintenance and anticoagulation of the catheter be ascertained.

The role of apheresis in the support of life-threatening ITP relapse.

A 14-year-old girl with chronic idiopathic thrombocytopenic purpura (ITP) presented in relapse with a platelet count of 1,000/microL and a high-level serum antiplatelet IgG antibody. She previously had been unresponsive to courses of therapy with steroids, vincristine, and splenectomy. When treatment with danazol and purified immunoglobulins was unsuccessful in controlling her rapidly progressive course, an 8-day plasma exchange procedure was initiated in combination with platelet transfusion therapy and immunosuppression with cyclophosphamide and vincristine.