<a, Figure 51. Left: Immature myelocytic cells (many promyelocytes) in marrow of subject No. 54, 6 weeks before death. X 1650. Right: Promyelocytes with Auer rods were numerous. x 1650. During the 1972 annual examination the sub- third molar, and a left chronic otitis media. Anti- ject was found to have a WBC of 2000 and a platelet count of 120,000. He showed noothersignificant findings and appeared to be a healthy and husky 19-year-old. He was brought to BNL, where a bone marrow examination revealed typical acute 6-thioguanine, heparin, oxacillin or cephalothin with gentamicin, and later ampicillin. He received blood and platelet transfusions, some from an myelocytic type with numerous Auerrods (see let levels continued low, and within 2 weeks he de- myelogencus leukemia, predominately of the pro- Figure 51). He was transferred to the National Cancer Institute at Bethesda, where examination resulted in few physical findings besides the bone marrow changes noted.* He had slight inflammation of the pharynx, periodontitis around the night “Drs. Edward S. Henderson, James Mabry, Joan Bull, Maria Tomaszewski, and Jacqueline Peng of the National Cancer Enstitute and Dr. Gundabhaktha Chikkapa of Brookhaven Natonal! Laboratory assisted with this study. leukemic medication included cytosine arabinoside, older brother flown in from the Marshall Islands, but compatible platelets were not available. Plate- veloped signs of a hemorrhagic diathesis with marked hemithorax. He was placed in respirator, but his condition worsened, and he died 6 weeks after admission. (See Appendix [1 for hospital summary. ) Theprincipal autopsy findings included acute myeloblastic (promyelocytic?) leukemiain spleen, lymph nodes, arachnoid, and bone marrow. There had been massive pulmonary hemorrhagebilaterally and inflammationof the parotid gland. It was Table 36 Difference in Mean Peripheral Blood Levels Between Subject With Leukemia (No. 54) and Exposed Peers WEC ( x 10-3) Neut. ( x 10-3) Exposed peers Leukemia case 77 5.7 (— 26%) 4.1 2.5 (—39%) 1955-72 Exposed peers Leukemia case 8. 6.5 (-—21%) 3.8 2.7 (—30%) 1934 Lymph.( x 10-3) Plate. ( x 10-3) Het., % 3.0 2.8 ( -6%) 246 187 (—24%) 37.3 36.4 ( —2.5%) 3.5 3.1 (-11%) 293 271 (—7.5%) 39.2 40.5 (43%)