In reviewing the literature on leukemia in which the disease is not accompanied by leukocytosis, one is immediately aware that such a condition has been recognized only in recent years, and also that reports of such cases are infrequent enough for one to look on them as of rather rare occurrence. Such a condition has been variously referred to as aleukemic leukemia, pseudoleukemia, leukemia with leukopenia and leukemia without leukocytosis.
Many writers refer to aleukemic phases in true leukemias, and a terminal leukemia is often observed in cases that throughout their course were considered typical; but cases showing no abnormal increase in the total white count throughout the entire illness are hard to find, especially if these cases are observed for any length of time. Litchfield1 reported the cases of two patients, one, aged 9 years, who had 7,000 white cells with 95 per cent lymphocytes. The second patient,