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A frequent change of drug combinations may circumvent drug resistance in the treatment of patients with acute lymphoblastic leukaemia (ALL). In study COALL 85/89 201 children with high-risk ALL were randomized to receive over a period of 8 months rotational chemotherapy with six drug combinations given either in slow rotation (SR) (each combination given twice in succession) or in rapid rotation (RR) (cach combination given once with a repetition of the drug combinations). Treatment of central nervous system leukaemia consisted of cranial irradiation and intrathecal methotrexate. Both SR and RR treatment groups were then given continuation chemotherapy of oral 6-mercaptopurine and methotrexate until 2 years after the date of diagnosis. The 9-year eventfree survival (EFS) rate for the whole group is 69%±3%, and the survival rate 75%±3% at a median follow up of 5.8 years. Failure to achieve remission at day 28 was the most important prognostic factor (EFS 12%±7% vs. 75%±3% in the remission group). In the RR group, 11/100 patients were not in remission at day 28 opposed to 7/101 patients in the SR group. Children aged <1 year (6/6 relapses) or aged >=10 years had a worse prognosis (EFS 64%±5% vs. 77%±4% in patients 1–10 years old). After 5 years EFS was inferior in the RR group attributable to a significantly higher relapse rate in children with a WBC>=100/nl. The EFS at 9 years for all patients, however, is similar in both groups (SR 72%±5% vs. RR 67±5%).

Bloedorn and Roberts1 recently reviewed the literature on abdominal muscle paralysis associated with herpes zoster, and reported a case. I am able to add another case:REPORT OF CASEE. S., a man, aged 66, a retired farmer, seen, Feb. 14, 1924, had a typical eruption of herpes zoster of the skin supplied by the fibers of the tenth right thoracic nerve trunk. The eruption had been present for two weeks before I saw him, but as the pain became severe, he sought medical attention. Physical examination showed marked pyorrhea alveolaris, but otherwise was negative, except that the patient had had constipation for years, which seemed to be made worse by the herpes zoster. He was given local treatment for the eruption. One week later I was again called because of a "tumor" of the abdomen and to relieve the constipation. At this time a protrusion of the right