Acute Granulocytic Leukemia in the Elderly

To the Editor.— Dr Crosby's editorial statement that "when acute granulocytic leukemia occurs in patients over 50, chemotherapy does not produce remissions"¹is at variance with our experience (Acute Leukemia Group B [ALGB]: Meeting minutes, Dec 4-6, 1974, protocol 7221) and that of others.²⁻⁶Although we agree with Dr Crosby that "the duty of the therapist is to the patient, not to his blood cell counts. We treat people, not diseases...,"⁷we do not subscribe to his intractable pessimism and gloominess that is exemplified by his assertion that "with the therapeutic agents we have today, there is no hope of cure."⁷ Several groups of investigators,²⁻⁶including ourselves, have reported favorable results with combination chemotherapy in acute granulocytic leukemia in elderly patients (Table). Between 1967 and 1971, we (ALGB) treated 451 patients with acute granulocytic leukemia who were more than 60 years of age. Twenty percent