or teem be Or heen wee me ee a es ci ed
~
thy
74x
Figure 31. Left: Framature myetucyvue cells (anaay promvelocytes) in marrow of subljevt No. 34,
toweeks before death, 3 LO00. Augat: Prouiyelucvies wath Auer rods were numerous, x 1650,
During the 1972 annual examination the subject was found to have a WIC of 2000 and a
platelet count of 120,000, He showed no other sig-
nificant findings and appeared ta be a healthy and
husky 19-sear-old. He was brought ta BND, where
a bone marrow cxanination revealed typical acute
mivelogenous leukemia, predominately of the promyeloeviic pe with numerous Auer rads (see
Figure 3b). He was transferred to the National
Cancer Institute at Bethesda, where examination
resulted in few physical findings besides the bone
tnarrow changes noted. * Efe had a slight inflamma.
dian of the pharynx, periodontitis around the right
Dr. Edward 8 Henageron James Malev, Joan Bull, Miaei
Tomaszewskic and Juscueline Poo od the Nutesal Cancer fue
ditute and Dy Guntdathakiha Chokkipa al Brovkbawen Nae
lated Laboeatory asseted wath thos stusly,
third molar, and a left chronic otitis media. Aatileukemic medication included evtasine arabinoside,
O-thioguanine, heparin, oxacitlin of cephalothin
with gentamicin, and later ainpicillia, Ele received
blood and phuelet trinsfusions, seme from an
older brother flown ia from the Marshall blancs.
but campatitde platclets were nat avaiable, Plate-
let levels continued low, aid within 2 weeks be developed signs of a hemorrhagic diathesis with
marked bemithorax. ble was placed ina respirator,
but his condition worsened, and he died G weeks
after adinission, (See Appendix It for hospital
Sullinary.}
The principal autopsy findings included acute
tnveloblastic (promyelocytic?) leukemia ia spleen,
lyinph nodes, arachavid, and bone marrow. Vhere
had been massive pulinonary hemorrhage bilaterally and inflammation of the parotid gland. [twas
‘Palde Wi
Difference in Mean Peripheral Blood Levels Beoccen Subject
With Leukemia (No. dd and Ex pened Peers
WROD xe poy
1d
Expaoscd peers
77
Neu. (x dey
‘1
Savraype. tx 10)
Place. (x bac ty
bhet..‘*
Leukemia case
V7 (20)
24 (-477)
ORC=a0%)
3.0
wie
IT Cardy
Te eee
SU
1904-72
Exposed peers
La-ukernia caw
ue
6 (Nt
w7 (arty
3.
4.5
“aC tl)
HLS
2 (7.4)
2
Hh (+ ty