The treatment of acute myelogenous leukemia in adults

An uncompromisingly optimistic approach must now be taken to the future of the treatment of acute myelogenous leukemia. This view can be justified on two grounds. First, understanding of the biology of the disease is increasing, resulting for example in the demonstration of the prognostic significance of the behavior of the leukemic blast cells in culture and their chromosomal pattern. It seems most likely that individualization of treatment will follow from such observations, with obvious benefit to the patients. Second it has been shown that a modest proportion of patients is cured with the manipulations of chemotherapy with or without radiotherapy and bone marrow transplantation practised in the mid-1970s. Selected results reflecting a personal bias have been presented allowing speculation that very intensive chemotherapy, possibly of short duration may be able to increase this proportion. At the same time, advances in the techniques of preparation of both patient and bone marrow for transplantation are being made and may increase the potential pool of patients who may benefit from the procedure. Even within the limitations of the treatment available now, it is possible that a flexible attitude to the precise manipulation of cytotoxic drugs, radiotherapy and transplantation may result in cure for the majority, rather than the minority, of patients.