To the Editor.
—Qualitative platelet abnormalities predispose to bleeding episodes in patients with acute leukemia.1,2 Although impaired platelet aggregation has been repeatedly observed in acute myelocytic leukemia,3 only three cases of patients with acute lymphoblastic leukemia (ALL) and abnormal platelet function have been previously reported.4 We report here an additional case with a metabolic defect not previously described.
Report of a Case.
—A 13-year-old boy was admitted to the Ohio State University Hospital with a large mediastinal mass and diffuse peripheral lymphadenopathy. The WBC count was 17,200/cu mm, with 12% T-cell lymphoblasts and 35% lymphocytes, and a bone marrow aspirate disclosed diffuse T-cell infiltration. He was treated to complete remission with a combination of cyclophosphamide, vincristine sulfate, doxorubicin, and prednisone. Maintenance treatment consisted of intrathecal prophylaxis followed by mercaptopurine, thioguanine, methotrexate, vincristine sulfate, and cytarabine in various combinations. One year after termination of all therapy, he remains in