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Septicaemias are frequent and severe in patients with acute leukaemia under aplastic treatment. The present study concerns 69 such patients: 29 with acute lymphoblastic leukaemia (ALL), and 40 with acute non-lymphoblastic leukaemia (ANLL). All were treated in single rooms in the same hospital and in similar conditions. The overall incidence of septicaemia was 62%; it was 60% in patients with recently diagnosed ALL and 68% during relapses. More than 34% of ALL patients and 82.5% of ANLL patients had one or several episodes of septicaemia. Among the 74 pathogens isolated 50% were Gram-positive organisms, 45% Gram-negative organisms and 5% Candida spp.. The first episodes of septicaemias were predominantly caused by Gram-positive spp. (61%) and the subsequent ones by Gram-negative spp. (60%). The primary infection could only be diagnosed in 19% of the cases and was most frequently located in the digestive tract or perineal region. The most common focal complications were lung infections (18 cases), skin infections (12 cases) and septic shock (15 cases). Seventy-four p. cent of the patients survived with prompt and potent antibiotic therapy. Death occurred in 26% and was clearly related to the following factors: chemotherapy of relapsed leukaemia and/or blastic aplasia and/or successive episodes of septicaemia. The incidence and severity of septicaemias in leukaemic patients will only be reduced by improved prophylactic measures against infection and by less pronounced and shorter chemotherapy-induced granulocytopenia.

The coexistence of a myeloma and Paget's disease in the same patient is only rarely reported in the published literature. The frequency of such an association was studied when reviewing 3 cases observed by the authors: an IgG myeloma discovered following a spasmodic paraplegia in a patient with Paget's disease; a patient who was found to have a myeloma, a polynuclear neutrophil leukemia, and Paget's disease; and an IgG myeloma in a patient with probable localized Paget's disease. The incidence of the association myeloma-Paget's disease is much lower than that of sarcomatous degeneration. It should be determined precisely, however, as our future conception of the reciprocal relationship between the two diseases is greatly dependent on this information. Furthermore, the very few cases reported, and their lack of homogenicity, are the reasons why most authors feel that the association of myeloma and Paget's disease as pure coincidence. Many new cases, however, have been recently reported. The problem of the significance of the association of Paget's disease and macroglobulinemia or other monoclonal gammapathies has still to be solved.

The role played by T lymphocytes in myelopoiesis has been established in in vitro studies. Dysregulation of the lymphoid system results in quantitative and, more rarely, qualitative abnormalities of myelopoiesis. The authors report the clinical data of two cases of peripheral T cell lymphoma associated with an AREB type of dysmyelopoiesis. The fact that both conditions were diagnosed simultaneously and progressed in parallel is an indirect argument in favour of the regulation of myelopoiesis by the T lymphocytes.

Mediterranean visceral leishmaniasis is not only a children disease. We observed 12 adult cases since 1971. Clinical presentation usually associates anarchic fever and splenomegaly, with anaemia, leucopenia, increased sedimentation rate and hypergammaglobulinemia. We must think to kala-azar, specially after a stay in an endemic country (mediterranean area), ask for parasites on bone-marrow smears and more often immunological diagnosis. Spontaneously fatal, the disease is easily cured by antimony derivatives.