The Influence of Chemotherapy on Survival in Acute Leukemia

One measure of the effectiveness of therapy in the treatment of acute leukemia is its influence on longevity. Median survival was calculated for 103 of our own cases and 782 cases published in the literature. These were divided into treated and untreated groups. Separate analyses were made for several modes of therapy.

It was not possible to demonstrate that the newer therapies (folic acid antagonists, ACTH, cortisone and 6-mercaptopurine) significantly increased the total survival in these representative groups. However, in those who achieved at least one complete remission, the median survival had been enhanced from four and a half to eight months, a difference which was found to be statistically significant.

Among the reasons for this rather surprising finding is the possibility that the use of chemotherapeutic agents may fail to alter the course of acute leukemia in some instances while prolonging it in others; the fact that of the series suitable for analysis which were found in the literature, only one was of a more recent date than 1952, although publications up to May 1954 were reviewed; and finally, that the use of 6-mercaptopurine was not adequately represented in the survey.