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July 1968

To Treat or Not to Treat Acute Granulocytic Leukemia

Arch Intern Med. 1968;122(1):79-80. doi:10.1001/archinte.1968.00300060081018

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Clinical and morphologic variants of acute granulocytic leukemia (AGL) exist, but such classification has not been regarded as of practical value or significance. In trials of new drugs, for example, all cases of AGL are lumped together as though all of the variants were similar in responsiveness. This permits more rapid accumulation of numbers of cases, but the statistical analyses are of dubious value because the variants do differ from one another. With some forms of AGL, the tried and accepted agents such as mercaptopurine and corticosteroids induce remission in a reasonable percentage of cases. With other forms of AGL, the remission rate is zero. Of more immediate concern than analysis of drug trials is the recognition of these differences when treating individual patients with AGL.

The following are some of the refractory varieties of AGL:

1. Blast Crisis.—Any  —Any of the chronic myeloproliferative diseases such as polycythemia vera, chronic

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