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Appendix LL... a'k* °
Hospital Summary of Leukemia Case
Admitted on 10-272 to National Cancer Institute, Hematology and Supportive Care Branch
“The patient {s a 19-year-old man from the Marshall Islands, who transfers
from
the hospical of the Brookhaven National Laboratory with a tentative diagnosis of acute
leukemia,
PRESENT ILLNESS:
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This patient hae been followed with yearly physicals and blood counts by the
Medical Research Center vf the Brookhaven Nacional Laboratory since age one, at which
at
Poy de
time he suffered an accidental radiation exposure of 175 total body rads.
He had a
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transient leukopenia one month following exposure but since then has had normal blood
counts at his yearly examinations. Ac the cime of a roucine evaluation in August 1972,
his peripheral blood white count was 1,200, platelee count 119,000, and red blood cell
count 4.4 million.
Actempe ac a bone marrow aspiration at that time was unsuccessful,
and on September 29, 1972, the patient was flown to the Brookhaven Medical Research
Center far further evaluacion. He had not complained of easy fatigability, spontaneous
or unusual brufsing or bleeding, joine or muscle aches, or an increased number of infec
tions. At the time of admission on September 29, the hemoglobin wus 12.5, white blood
cell coune 700 with 26% polys, 28% lymphocytes, and the remainder abnormal monocytic
precursors,
Urinalysis, liver function tests, and prothrobin time were all within
normal limits. A bone marrow aspirate in the left posterior iliac crest was performed
and revealed a predominance of early myeloid precursors with some dissociation of cyto-
plasmic and nuclear maturation and presence of Auer rods in the cytoplasm of myeloblasts.
On September 30, the patienc had an asymptomatic temperature elevation to 101°F,
Physical examination then revealed slight injection of the pharynx and a chronically scar-
ved left tympanic membrane.
Chese x-ray was normal,
Cultures were taken, and the
patient was begun ac thac time on treatment with keflin and gentamicin. He was placed
on isolation, On October 1, the paciene was afebrile, and arrangements were made to
“Peay aif
transfer him here.
PAST HISTORY:
| Qperarions:;
Accidents:
Medicines:
”FAMTCrY HISTORY:
Subtotal thyroidectomy.
None
Occasional “Anacin™ tablet; synthroid, 0.3 mg. daily from 1968 until
May 1972,
Mother, father, six brothers, and three siatcrs are all living and in good health
in the Marshall Islands.
Clinica, BCORD
Kh ier end Phguael &
Rongelap (54) 09-44-40 3
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THE CLINICAL CENTER
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