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A 43-year-old woman who developed thrombotic thrombocytopenic purpura was treated successfully with high doses of prednisone and a splenectomy. Imprints from the cut surface of the spleen showed marked phagocytosis of all the cellular elements of the blood. This observation suggests that hypersplenism, in addition to vascular occlusion, may play a major role in the physiopathology of some cases of thrombotic thrombocytopenic purpura.

In 30 non-anemic, and in 7 non-thalassemic, anemic pregnant women the red cell mass (RCM) was determined at 32-36 weeks of pregnancy, using isotopes, and was correlated with red cell 2,3-DPG, using the method of Keitt. The increase in 2,3-DPG in pregnant women with low RCM was in the same range as in those with increased RCM. Thus, 2,3-DPG can not be used to diagnose a RCM deficit in pregnancy. The relationship between 2,3-DPG and RCM in the third trimester was complex: in the 7 anemic women there was an inverse relationship, which failed to reach statistical significance, probably because of the small number of cases; in the 30 non-anemic women there was a significant, positive correlation between 2,3-DPG and RCM. The cause of this positive relationship needs further investigation.

The clinical features, therapy, and hospital course of ten consecutive patients with malignant histiocytosis (MH) are presented. The value of bone marrow aspiration for the diagnosis is discussed. The patient's performance status as described in this report by the organ dysfunction score may predict survival and response to chemotherapy. The literature on chemotherapy in this disease is reviewed. Combination chemotherapy may be the best approach to treatment, but there is little experience with single agents. There is a great need for better characterization of the malignant cell in this disorder.

The hematological features of phenacetin-induced hemolytic anemia are presented in order to make the physician aware of the abnormalities which suggest the use of an oxidant drug. The presence of "bitten out" red cells is the commonest initial clue to the existence of drug-induced hemolytic anemia. The diagnosis is confirmed by the demonstration of Heinz bodies and sulfhemoglobinemia. Early recognition of this form of drug-abuse may avert the development or progression of analgesic nephropathy.

It has been claimed repeatedly that iron stimulates hemoglobin formation in normal men and women. Because of the inconclusive evidence in the literature, the possible stimulatory action of iron on normal hemoglobin synthesis was reinvestigated by evaluating the effect of 1000 mg. of intramuscular iron on hematological parameters in six normal men and six normal women over a six-month period. Determinations of red cell and hemoglobin mass after three and six months and monthly determinations of hemoglobin concentration, packed cell volume, red cell count, reticulocyte count, mean corpuscular volume and mean corpuscular hemoglobin concentration showed no significant rise in either the men or the women. It is concluded that there is no demonstrable proof that the administration of iron stimulates erythropoiesis or hemoglobin synthesis in iron-sufficient normal men and women.