Kinetically oriented manipulation of drug management in acute leukaemia

The evaluation of the kinetic characteristics of the blast population in AL, at the outset of the disease, establishes its growth rhythm and hence the degree of invasivity. Cases with a higher 3H-Tdr labelling index also display a higher growth fraction, birth and growth rates and a shorter generation time, in other words, greater cell growth potential and invasivity. The labelling index could thus represent an immediate guide to prognosis. Particularly when combined with other prognosis factors, it can be employed to divide AL into high and low growth and invasivity forms. A distinction of this kind can thus be made the basis of differentiated therapeutic programming, whereby more or less aggressive cytocidal drug associations and doses can be administered to improve the therapeutic index and the quality of life.