[Chemotherapy for chronic leukemia]

Chemotherapy for chronic myelogenous leukemia is divided into two parts; chronic phase and blastic phase. The most distinguished new attempt for chronic phase in recent years in the former was the L-15 protocol, intensive multicombination chemotherapy by Clarkson and his group, which destroyed a large fraction of the leukemic population and permitted repopulation of the marrow with predominantly Ph1-negative cells in about half of the patients. However, most of the complete remissions were of short duration. On the other hand, much progress has been made in the chemotherapy for blastic phase cases. Using a combination chemotherapy of vincristine and prednisolone, over one-third of the patients with CML in blastic crisis have achieved a complete remission. Survivors over one year from the blastic crisis are rapidly increasing in recent years. Chemotherapy for chronic lymphocytic leukemia at the stage III of Rai's staging is recommended to start with chlorambucil, cyclophosphamide or corticosteroids.