TREATMENT OF ACUTE LEUKEMIA

Abstract

IN TREATMENT of acute leukemia in children, as in treatment of any form of cancer, early diagnosis is of great importance. Although in contrast to many other tumors in children, leukemia is never curable even when detected at the early stages, the sooner treatment can be initiated, the more chance there is of having sufficient time to achieve a beneficial effect. The most important single factor in making the diagnosis of leukemia is a high degree of suspicion. Patients with pains in the bones and joints, with any hemorrhagic tendency, with increased susceptibility to infection or with an unexplained anemia or fever should have an immediate determination of total and differential leukocyte count, hemoglobin, and platelets. If any abnormality is found or if the symptoms persist, a bone marrow aspiration is essential. If these procedures are utilized, it is the rare case in which the diagnosis cannot be made with relative ease. In most cases of acute leukemia, there is almost complete replacement of the normal elements in the marrow by leukemic cells. Depression or absence of erythropoietic activity in the marrow and possibly decreased life span of the circulating erythrocytes leads to severe anemia with the accompanying symptoms of pallor, easy fatigability, and dyspnea on exertion. The decreased megakaryocytic activity in the bone marrow and the decrease of platelets in the circulating blood lead to petechiae, ecchymoses, and other hemorrhagic manifestations. In the peripheral blood the total leukocyte count may be high, normal, or low but, as most of the cells are abnormal in type, the patient is less able to combat infection.