To Treat or Not to Treat Acute Granulocytic Leukemia. II

In a recent editorial in this journal1Crosby expressed the opinion that there are certain varieties of acute myeloblastic leukemia (AML) in which specific antileukemic therapy should not be employed. Specifically, he stated that the following types of patients are "not improved by chemotherapy": those with such morphologic subvarieties of this disease as myelomonocytic, promyelocytic, and acute granulocytic leukemia with megaloblastosis (erythroblastic leukemia); patients with the smouldering type of acute leukemia, and patients over the age of 50. In a previous study,2we were unable to demonstrate any influence of cell type or age upon the rate of response of AML to mercaptopurine. However, the number of patients treated with mercaptopurine in that series was small (63 patients) and experience with certain of the less common varieties of the disease was limited. We therefore have reviewed patients treated in our clinics since that date in order to enlarge