Of 157 long-term survivors with acute leukemia, 103 are Iiving and well with no evidence of disease (NED) 5 to 17 years from the diagnosis. Of these 103, 48 have been off therapy for a year or more, 43 for 2 or more years, 29 f o r 5 years or more, and 10 f o r 10 years or more. Survival curves suggest that over 50% of the 157 patients who have survived more than 5 years should survive 15 years. The author's data suggest that in the patient treated for 7 years and NED for at least 4, therapy may be discontinued. In Burkitt's tumor in Africa 38 of 245 treated cases (15.5%) have been in unmaintained remission f o r from one to 7 years. The authors suggest that in the United States all abdominal and extranodal lymphoma in children, except Hodgkin's disease, be treated as is Burkitt's tumor in Africa with Cytoxan, 40 mg/kg every 3 weeks, plus obliterative radiotherapy where disease appears localized.
.WENTY YEARS AGO THE OUTLOOK FOR THER-T apy of acute leukemia was extremely bleak. Southam et al.,Z5 reporting the experience at Memorial Hospital from 1926-1947, found that only three of 150 patients in a series of both adults and children survived more than a year and all were dead by 14 months.
in reviewing 218 cases of untreated acute leukemia in children, found a median survival time of 3.9 months from the first symptoms of the disease to death, and a 10% survival of approximately 10 months.
In the rare cases of long-term remissions reported in the literature prior to this time there was usually some question of the diagnosis and Forkner,lo in reviewing those reports published between 1852 and 1437, considered that in all except possibly three or four cases the diagnosis of acute leukemia was not adequateIy substantiated. Since the results of therapy were so unpromising, the physicians From the Division of Drug Resistance, Sloan-