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Acute Leukemia Forum 2000, Advances and Controversies in the Therapy of Acute Myelogenous Leukemia

The treatment of acute leukemia: past, present, and future

Leukemia volume 15, pages 658–661 (2001)Cite this article

Thank you very much, Marshall, for that very generous introduction. I'm going to talk about the past because it is always interesting to contemplate how we have gotten where we are; I will say very little about the present because I have been here at this meeting to learn about it; and, finally, I will talk about the future because I think there are some exciting new ideas that may accelerate us from the plateau that we seem to have reached in the treatment of acute leukemia, and because it will be a long time before you can prove that I was wrong.

According to Gunz,1 Velpeau described the first case of leukemia in 1827. His patient's history was presented as follows: ‘A florist and seller of lemonade who had abandoned himself to the abuse of spirituous liquor and of women, without, however, becoming syphilitic’ presented with pronounced swelling of the abdomen, fever, weakness, and symptoms of urinary stones. He died soon after admission to hospital. In Velpeau's day, the first diagnostic crossroads was the classification of patients either as syphilitic or nonsyphilitic. The patient had an enormous liver and spleen, ‘blood like gruel’, and he died very quickly. But the real origin of the understanding of leukemia as an entity occurred quite fortuitously in the same year, 1845, by the great German pathologist, Rudolf Virchow, and the British pathologist, John Bennett. Virchow was a mere 24 years of age when he described this entity, and Bennett was not much older. Virchow named the disorder leukemia and John Bennett named it leukocypenia. This difference in nomenclature, the beginning of many conflicts about nomenclature in this field, resulted in vigorous and acrimonious debate over many years. Moreover, John Bennett thought that the disease was a form of pyemia, a suppuration of the blood. Virchow did not agree with this formulation, regarding leukemia as arising in the organs that produced blood cells. Virchow and Bennett fought over this problem for approximately 20 years, with Virchow turning out to have been correct.

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Beutler, E. The treatment of acute leukemia: past, present, and future. Leukemia 15, 658–661 (2001). https://doi.org/10.1038/sj.leu.2402065

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