Clinical and immunological correlates of leukemia cutis in childhood

Clinical features of three children with acute lymphoblastic leukemia complicated by leukemia cutis are described. All three patients appeared to have null cell disease, in contrast to adult cutaneous lymphoproliferative diseases which are generally T-cell disorders. Morphologically normal bone marrow specimens from one of these patients plus an additional four patients with isolated extramedullary relapses were also studied and found to be reactive to antisera defining leukemia associated antigens and/or human Ia-like antigens during six of eight relapse episodes. Such data may imply the need for systemic as well as local therapy when "isolated" extramedullary relapse occurs.