Blood, 1959, Vol. 14, No. 7, pp. 828-847.
© 1959 American Society of Hematology, Inc.
The Influence of Chemotherapy on Survival
in Acute Leukemia
Comparison of Cases Treated During 1954 to 1957
with Those Treated During 1947 to 1954
ARTHUR HAUT 1,
STANLEY J. ALTMAN 1,
M. M. WINTROBE 1, and
G. E. CARTWRIGHT 1
1 Department of Medicin, University of Utah College of Medicine, Salt Lake
City, Utah.
The longevity, reckoned from the symptomatic onset of acute leukemia as
well as from the initiation of treatment, of a group of 89 cases including
children and adults, treated in this clinic since March, 1954, was found to
exceed that of a similar group of 78 patients treated in preceding years in
the same clinic. The median survival of all cases considered as a unit was
increased from three to six months, as measured from the date treatment was
begun. The change was found to be statistically significant as well as clinically
important. The longer survival found in the 1954-57 series correlated with the
greater use of three, rather than only two, chemotherapeutic agents.
On analysis, improved survival was statistically proven only for individuals
with lymphoblastic leukemia; for these, the median survival was 10 months
after the symptomatic onset of leukemia and 7
months after the start of
treatment. Within this group, there was an even greater improvement for
those whose leukocyte values immediately prior to the initiation of therapy
were less than 10,000 per cu.mm.; half of these patients lived more than 12
months after treatment was begun. The reason for the exceptional longevity
of patients with the lower pre-treatment leukocyte values is unknown. It
appears that one can attribute at least part of the improvement to therapy.
The type of statistical analysis used presents the minimum figures for improvement in median survival. When the ultimate longevity is known for the
17 per cent of the cases surviving at the closing date of the study an additional
small increment may be found.
The relative inefficacy of chemotherapy in myeloblastic leukemia should
be a signal for greater screening of new agents in this type of tumor.
Submitted on November 25, 1958
Accepted on December 27, 1958
