Autotransplants are increasingly used in chronic myelogenous leukaemia (CML). Most are performed in advanced leukaemia; now, autotransplants in chronic phase are being evaluated. Treatment involves high-dose chemotherapy with or without radiation followed by a transplant of previously cryopreserved stem cells derived from bone marrow or blood. The transplanted bone marrow may be manipulated in vitro to remove CML cells. Results vary. Transplants in advanced CML usually re-establish chronic phase but responses are brief. After transplants in chronic phase some recipients become Philadelphia chromosome negative for a year or more; others remain Ph-chromosome positive. There are insufficient data to show whether these early transplants prolong chronic phase duration or increase survival. The incurability of CML by conventional therapy should encourage further studies of this approach.

5 sets of criteria for diagnosis of Behçet's disease are in use--a problem which has hindered interpretation of different studies and collaborative research. An international study group, which included at least one proponent of 4 of the sets, was formed to derive new, internationally agreed diagnostic criteria for Behçet's disease. Data on 914 patients with Behçet's disease, from 12 centres in 7 countries, were compared with controls from the same centres. The new set of diagnostic criteria--which requires the presence of oral ulceration plus any two of genital ulceration, typical defined eye lesions, typical defined skin lesions, or a positive pathergy test--was simpler to use and had an improved discriminatory performance than its predecessors.

To develop guidelines for ranking the urgency with which patients with angiographically proven coronary disease need revascularisation procedures, factors that a panel of cardiac specialists agreed were likely to affect urgency were incorporated into 438 fictitious case-histories. Each panelist then rated the cases on a 7-point scale based on maximum acceptable waiting time for surgery; 1 on the scale represented emergency surgery and 7 delays of up to 6 months. For only 1% of cases was there agreement on a single rating by at least 12/16 panelists. Results of this ranking exercise were used by the panel to draw up triage guidelines. The three main urgency determinants were severity and stability of symptoms of angina, coronary anatomy from angiographic studies, and results of non-invasive tests for risk of ischaemia. Together these three factors generally gave an urgency rating for any given case to within less than 0.25 scale points of the value predicted with all factors. A numerical scoring system was derived to permit rapid estimation of the panel's recommended ratings.

The international incidence of myeloid leukaemia, cancer of the kidney, melanoma, and certain childhood cancers all show significant correlation with radon exposure in the home. For myeloid leukaemia, analysis suggests that in the UK 6-12% of incidence may be attributed to radon. In Cornwall, where radon levels are higher, the range is 23-43%. For the world average radon exposure of 50 Bq.m-3, 13-25% of myeloid leukaemia at all ages may be caused by radon.