Acute leukaemia related to chlorambucil therapy for juvenile chronic arthritis

We report the case history of a boy with juvenile chronic arthritis, complicated by amyloidosis, who was treated with chlorambucil. He later developed an acute leukaemia and died. The published reports of malignancies developing in children following the use of this drug are reviewed and it was seen from these that cytotoxic drugs should be reserved for treating the life threatening complications of non-malignant diseases of childhood.