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The prevalence of serum antibodies to hepatitis A virus (HAV) in 793 hemophilia A (HA) and 89 hemophilia B (HB) patients coming from 10 French Hemophilia Centers and treated since 1986-1987 with solvent/detergent (SD)-treated products is reported. The results indicated seropositivity to HAV of 29.9% in HA and 40.4% in HB patients. There was no difference among the patients according to severity of the disease, HIV serology or administration of factor VIII during the last 12 months. Seropositivity increased with age from 5.2% in HA children to 42.4% in adults (in HB the respective prevalences in the same groups were 7.7% and 56.1%). When compared to normal controls (n = 585), the prevalence of HAV seropositivity was not excessive in HA patients (n = 206). 19/20 children exclusively treated with a very-high-purity SD-factor VIII concentrate (Centre régional de transfusion sanguine, Lille) remained HAV seronegative. Six cases of HAV contamination were reported in patients with severe HA, probably reflecting the level of HAV endemy in the normal population in France. No special risk of HAV transmission linked to the SD products used in France since 1986 had thus been identified.

From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.

Among fifty patients with bone metastases from breast cancer who were hospitalized between 1971 and 1980, 19 were given intermittent chemotherapy including both hormone-therapy (drostanolon propionate and tamoxifen) and a combination of cyclophosphamide, methotrexate, 5 FU, doxorubicin and vincristine (CMFDV). Comparison of these patients with two other groups given either miscellaneous chemotherapy programs (19 cases) or no chemotherapy (12 cases) exhibited the value of the standardized protocol, especially concerning median survival which exceeded three years (versus one year with the two other methods). Cobalt-therapy, chemotherapy and hormone-therapy in bone metastases from breast cancer are reviewed.