Advances in chemotherapy for leukemia—January 15, 1994

Advances in chemotherapy for leukemia—January 15, 1994

In the 1970s, chemotherapy for acute leukemia made significant progress within the medical community, with a 3-year survival rate of 35%–70% for acute lymphoblastic leukemia (ALL) and 30%–45% for acute non-lymphocytic leukemia (ANLL). Bone marrow transplantation (BMT) further opened up new avenues for treating these diseases. However, since the 1980s, treatment for these conditions has stagnated. BMT has not seen significant improvements, with long-term efficacy roughly on par with chemotherapy; although many new chemotherapeutic drugs have been developed, overall they show no significant difference compared with older medications. In terms of chronic leukemia treatment, aside from allogeneic BMT curing a small portion of chronic myelogenous leukemia, chemotherapy remains at the level of the 1950s and 1960s, with no cases cured by chemotherapy. Currently, the biggest challenge is relapse; once it occurs, survival rates are very low. High-dose chemotherapy is undoubtedly an important measure to prevent relapse, and allogeneic BMT between identical twins can enable 40%–60% of patients to achieve relapse-free status. For ALL, after induction chemotherapy, consolidation chemotherapy should be maintained for at least 3 years; for ANLL, consolidation typically requires 6–8 months.