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The French--American--British co-operative study group (FAB) criteria were used to classify acute leukaemia in 194 adult patients. The dividing lines between FAB subgroups M1--M2 and M5A--M5B appeared to be less well defined. In an effort to improve subtyping we introduce the maturation index (MI). (formula: see text). Clearly distinct subgroups emerged after arrangement of cases according to MI values. Immature and rather mature cases in both myeloblastic and monoblastic leukaemia were divided at a MI of 4%. Assignment to M3, which is based essentially on morphological grounds, could be made on numerical grounds too, MI being at least 85% in all of our cases. A few cases showing M2 morphology and a positive alpha-naphthylacetate esterase (ANE) staining should probably be categorized as M4. Application of the original FAB criteria resulted in disagreement of 14% between three investigators, while with our additional criteria the discrepancy was only 2%.

A patient is described with immunoblastic non-Hodgkin's lymphoma and autoimmune haemolytic anaemia of the cold autoantibody type. The autoantibodies were monoclonal IgM-kappa cold haemagglutinins/haemolysins with blood-group specificity, anti-P. Red-cell autoantibodies directed against blood-group-P antigen have until now only been detected, as polyclonal IgG antibodies, in paroxysmal nocturnal haemoglobinuria.

Neutrophils with ring-shaped nuclei were found in 12 out of 28 patients with myeloproliferative disease and only rarely in patients with toxaemic granulocytosis and in healthy controls. Nuclear ring formation and hyposegmentation appeared to be significantly related. Recently we became aware of the occasional occurrence of neutrophils with ring-shaped nuclei in patients with myelodysplastic syndromes (MDS) and in chronic granulocytic leukaemia (CGL). Ring formation is a well-known feature of granulopoiesis in rodents. To our knowledge it has not been described in man. We therefore report here on a search for ring neutrophils in peripheral blood smears of patients and controls.