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Treatment of Chronic Leukemias^1,2,3,

Portland

ABSTRACT

Results of treatment of 212 chronic lymphocytic leukemias and 114 chronic granulocytic leukemias with the method of titrated, regularly-spaced total-body irradiation are presented, with data on survival time, comparative effectivness Of P³² and x-ray, radiobiologic observations, complications of the disease and therapy, and prognostic factors. The reason why this group of patients has had a better survival than any other published series of leukemias treated by other methods is now apparent in the light of my unifying concept of the fundamental nature of malignancies. The action of ionizing radiation is to decrease the rate of cell division and thus to decrease the risk of further genetic change to a still shorter life span of the involved somatic n cell. In other words, the ionizing radiation substitutes for the alpha-2 alpha and alpha-n division inhibitors. The effect on cell division does have a threshold. The roentgen equivalent man for either cells of the lymphocytic series or granulocytic series is 1.0 mc of P³² intravenously in the adult equals about 15 r of total body irradiation.

The important variable influencing prognosis appears to be age and sex, with the female patients and the younger patients doing far better than the male patients and the patients over 61 at onset of the disease. The common complications and their treatment are outlined.

FOOTNOTES

¹ This work was supported in part by grants from the U.S. Atomic Energy Commission, Contract AT( 45-1)-581; the U.S. Public Health Service, National Cancer Institute grant CY-3374; and the Medical Research Foundation of Oregon.

² Presented in part before the 10th International Congress of Radiology, Montreal, August 29, 1962.

³ Drs. Robert H. Bigley, Robert D. Koler, Bernard Pirofsky, and Arthur J. Seaman collaborated in the care of these patients.

⁴ Professor of Medicine; Head, Division of Experimental Medicine, University of Oregon Medical School, Portland, Oregon.