Removal of fish-hooks.

(1) Aplasia following irradiation, accidents where any single dose received was above 400 r, sine the risk of death is greater than 50% above this level.' (2) Post-hepatitis aplasia. Tne mortality of this severe marrow depression is in the region of 10%,2 and marrow transplanation has been successul in two Tecently reported cases.2 3 (3) In severe aplasia when an identical twin donor is available, sine marrow can be transfused without pre-graft immunosuppression and graft-versus-host disease does not occur. (4) Children with aplasia seem to have a much better chance of a successful graft than do adults. In Storb's series of 24 patients4 a successful graft was obtained in seven of nine patients under 16 years of age compared with four of 13 aged 17 years and older. Furthmore, the encouraging figures that Stoeb presents represent results of transplantation in patients who had not been supported by full conventional treatmenthalf the patients had bacterial infections at -he time of admission and most had received frequent transfusion therapy, both these features prejudicing the successful outcome. As Storb points out, early transplantation before major infection and refractoriness to platelet trasfusions occur would offer much better results. Now that more is known about the problems of graft rejection and graft-versus-host disease in man it seems right to (be optimistic about the future of lbonne mrrow transplantation in aplastic anaemia, and it is to be hoped that this procedure will be applied more often in appropriate cases.-I am, etc.,