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November 18, 1974

Acute Leukemia: Its Smoldering Phase, or Leukemia Never Starts on Thursday

Author Affiliations

Washington, DC
From the George Washington School of Medicine, and the Washington Hospital Center, Department of Internal Medicine, Washington, DC.

JAMA. 1974;230(7):985-986. doi:10.1001/jama.1974.03240070019018

... and I awakened in the morning, burning up with fever. My gums were sore and bleeding and I was covered with huge black and blue marks. I was so weak I could hardly get out of bed. Doctor, it all began last Thursday morning.

THE diagnosis was acute leukemia and this is how the disease appeared to begin. But, of course, it didn't start last Thursday, or Tuesday a week ago, or indeed any specific day, for leukemia in most instances probably begins insidiously and may be present for weeks, months, or even years before it becomes apparent to the patient and then to the physician. Many factors influence this: the tolerance of the patient for his symptoms, his medical sophistication and that of the community, the alertness of the physician, and other reasons.

Indolent Nature of Acute Leukemia  It is our premise that most, if not all, acute leukemia