Brian was diagnosed three years ago with null cell acute lymphocytic leukemia. His age (15 years) and his initial white blood cell count (28,000/m3) portended a difficult road ahead. Four weeks of vincristine and prednisone failed to induce a remission, another poor prognostic factor, but finally remission was attained at week 6. Just 12 months from diagnosis, Brian suffered a bone marrow relapse. The philosophy of our division is to consider bone marrow transplantation in acute lymphocytic leukemia (ALL) patients at the time of their second remission. Remission was induced with aggressive chemotherapy that included vincristine, prednisone, L-asparaginase, and daunorubicin. Bone marrow was transplanted from an HL-A identical sibling I month later. His course was complicated by transient electrocardiogram (EKG) abnormalities, graft v host disease of the skin and gut, upper gastrointestinal hemorrhage, mild renal dysfunction, and intermittent fever. Brian is currently 18 months post-transplant. He suffers from chronic graft v host disease manifested by decreased range of motion in some joints secondary to scleroderma. He sees a physical therapist three times weekly for whirlpool treatments. He also has intermittent sinusitis and mild obstructive airway disease. A senior in high school, Brian is active in many school and church activities. His description of his experience with cancer points out his positive attitudes throughout therapy and his desire to have a normal healthy adulthood.