One of the great hematologists of our midcentury, a good physician, and an outstanding clinical investigator, one who earned that accolade in an era when studies of toad bladder did not qualify as clinical research was E. E. Osgood. One of Osgood's long-term studies, extending even to his death, concerned the treatment of chronic myeloproliferative disorders, granulocytic anemia, thrombocythemia, and polycythemia. He treated his patients with radioactive phosphorus (32P), and he employed it according to his procedure of "titration."1 Both the agent and the procedure have been abandoned.32P is expensive and, for the therapist inconvenient. However, for the patient it is most convenient: an injection every four to eight weeks and without risk of the extrahematologic side effects inherent in chemotherapy. Osgood's titration of the dosage spared the patient another risk, that of druginduced aplastic marrow.
Titration also is inconvenient, requiring that each patient receive a
Crosby WH. Therapy of Chronic Granulocytic Leukemia. Arch Intern Med. 1977;137(12):1717-1718. doi:10.1001/archinte.1977.03630240051017