Leukaemia accounts for less than 5% of the total number of malignant diseases in the USA {McCredie et al., 1976),· while about 9% of all neeplasros in the Netherlands originate in the lymphatic and blood forming organs. Because of the relatively easy accessibility of the turnoor cells in both the blood stream and the bene marrow, leukaemias have been stuclied extensively in attempts to gain insight into 'the growth pattern of malignancies. The results obtained with leukaemia have contributed consiàerably to the management of many ether malignant disorders in which the tumour cel! popuiatien is less accessible. Of the two main categories of acute leukaernia, only the treatment of acute lymphatic leukaemia (ALL) in children has greatly improved over the last decade. The survival curve for this leukaemia bas reached a plateau at a level of 55% after 5 1/2 years of continuous remission (Pinkel, 1979). However, a remarkable difference is observed between the response of children and adults with the same type of leukaemia and on similar treatment regimens. The results in adults are considerably less favourable (Clarkson et al., 1975). Impravement in the results of treatment of the ether main type of acute leukaemia, acute myelocytic leukaemia (AML), has been much less impressive. For this disease the prognosis in children and adults is similarly poor today. Prior to the development of chemotherapy, the disorder showed a r"a.pid and progressive downhill course in the majority of patients. More than circa 20% of the patients died within two weeks, circa 80% did not survive for two months and less than circa 5% of them lived longer than 6 months (McCredie et al., 1976; Frei and Freireich, 1965}. Following the development of effective chemotherapeutic agents, treatment results have improved. With the presently employed combination treatments, the frequency of complete remisslons (defined as a state in which the leukaemie cells in the bene marrow are below 5% and the peripheral blood counts are normal; for about 70% in optima! clinical situations details see Chapter 3) is (Clarkson et al., 1975; Meered ie et al., 1976; Gale et al., 1977; Cassileth et al., 1977; Preisler et al., 1977). their median duration is However, the majority of remissions is less than one year and fewer than 20% short, exceed 11 two years (Clarkson et al., 1975; Spiers et al., 1977a; McCredie et al., 1976; Gunz 1 1977). The fact that the duration of remisslons bas not significantly increased over the past few years indicates that present day therapeutic approaches are inadequate

, , ,
D.W. van Bekkum (Dirk)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Colly, L. P. (1980, January 9). Chemotherapy in a transplantable myeloid leukaemia in brown Norway rats : studies on BNML as a model for human acute myeloid leukaemia. Retrieved from http://hdl.handle.net/1765/31426