Study of the chemotherapy of leukaemia

Since the recognition of the disease one hundred years ago, the treatment of leukaemia has passed through two main phases. During the first fifty years treatment was by chemical agents. A ,large variety underwent clinical trial and some were found to temporarily influence the leukaemic process. Unfortunately many were highly toxic, and probably on account of this and our ignorance f their mode of action. they became known as cytotoxic agents. The discovery of x -rays in the early part of the Present century led to a new a_Dproach in treatment, and radiotherapy thereafter was generally accepted, by most clinicians, as the treatment of choice for the chronic variety of leukaemia. During the past decade, however, interest has been renewed in chemotherapy, and it seems likely that we are now on the threshold of a second era of chemotherapy. Since the Second World sudar a considerable amount of research in this subject has been carried out in the United Kingdom and the United States of America and to a lesser ;extent in other parts of the world. As a result 1 number of chemical agents have been discovered which materially influence not only patients with chronic leukaemia but also those with the more rapidly fatal acute disease. Their introduction has come about in one of three ways: (a) the observation that a compound being investigated for other reasons has a depressant effect on haemopoietic tissues - for example nitrogen mustard and urethane; (b) the synthesis of compounds related chemically to substances already known to be effective, such as in the case of triethylene melamine, triethylene phosphoramide, and 1:4- dimethanesulphonyloxybutane (Myeleran); and (c) the synthesis of analogues of nucleic acid precursors. Much attention is now being focussed on the last group of compounds. It is an entirely new field of research in chemotherapy and is considered by many investigators to be a more rational approach to the problem. Not only have some, e.g. the folic acid analogues and the purine analogue 6- mercaptopurine, resulted in dramatic 'remissions in patients with acute leukaemia, but with the aid of modern scientific techniques information has been obtained relating to their mode of action In addition their importance as a stimulus to research into biochemical processes connected with nucleic acid metabolism in the normal, leukaemic and neoplastic cell as a whole, probably outweighs their present therapeutic value.

Grantor dc:publisher

The University of Edinburgh

Year dc:date.issued

1956

Author dc:creator

• Fountain, James R.

Handle dc:identifier.uri

http://hdl.handle.net/1842/28051

OAI identifier oai:identifier

oai:era.ed.ac.uk:1842/28051