Leukemia

About Leukemia - Historical Perspectives

Reprinted from Childhood Leukemias with permission from Cambridge University Press; edited by St. Jude pediatric oncologist, Ching-Hon Pui, MD.

Since its initial recognition 150 years ago, leukemia has been the focus of remarkable research activity and consequent progress.  By 1913, leukemia could be classified as chronic lymphocytic, chronic myelogenous, acute lymphocytic, myeloblastic or monocytic, or as erythroleukemia. Progress in the description of leukemia has continued to parallel the development of new technologies, such as special staining, electron microscopy, chromosomal analysis, immunophenotyping and molecular genotyping.

In 1962, St. Jude Children's Research Hospital was opened in Memphis, Tennessee, with a mandate to seek prevention or cure of childhood leukemia.  A curative approach to children with acute lymphoid leukemia was initiated, consisting of four treatment phases:  remission induction, intensification or consolidation, preventive meningeal treatment, and prolonged continuation therapy.  Since 1970, many institutional and collaborative groups throughout the world, using the same four phases of treatment but with modifications of drug selection and dosage schedules, have confirmed the curability of acute lymphoid leukemia in children.

In the 1980s and 1990s, improved cure rates of up to 70% were reported.  Much of this improvement was related to more positive attitudes and greater clinical skill with experience, a remarkable increase in hematology/oncology medical and nursing specialists, better means of prevention and treatment of infection, more availability and use of blood components, earlier diagnosis and treatment, increased governmental and private health insurance coverage, and improved childhood nutrition...But the discovery and judicious introduction into treatment of additional antileukemia drugs...and modification of drug schedules... was also important.

"The value of history is not just in savoring the past, but in appreciating how it illuminates the present and guides us into the future. Several lessons can be learned from the study of the history of leukemia, particularly childhood leukemia. One is the importance of heeding new facts and listening to new ideas and hypotheses. At each point in the history of leukemia there have been instances of lost time and opportunity because of unreasoned resistance to innovation. It is important for physicians and scientists to be open to new thinking that challenges conventional wisdom and ways.”

Donald Pinkel, MD
Medical Director, 1961-1973
St. Jude Children’s Research Hospital

 

Childhood Leukemias is available in the libraries of most medical schools and from major book sellers.

Ching-Hon Pui, M.D.
St. Jude Children's Research Hospital
Publisher: Cambridge University Press
ISBN: 0521581761