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