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Fig. 5.118 Five-year relative survival rates after<br />

diagnosis of leukaemia.<br />

REFERENCES<br />

1. Freireich EJ, Lemak N (1991) Milestones in Leukemia<br />

Research and Therapy, Baltimore, Maryland, Johns Hopkins<br />

University Press.<br />

2. IARC (2000) Ionizing Radiation, Part 1: X- and Gamma<br />

Radiation and Neutrons (IARC Monographs on the<br />

Evaluation of Carcinogenic Risks to Humans, Vol. 75),<br />

Lyon, IARCPress.<br />

3. Noshchenko AG, Moysich KB, Bondar A, Zamostyan<br />

PV, Drosdova VD, Michalek AM (2001) Patterns of acute<br />

leukaemia occurrence among children in the Chernobyl<br />

region. Int J Epidemiol, 30: 125-129.<br />

4. IARC (2002) Non-ionizing Radiation, Part 1: Static and<br />

Extremely Low-Frequency Electric and Magnetic<br />

Fields (IARC Monographs on the Evaluation of<br />

Carcinogenic Risks to Humans, Vol. 80), Lyon, IARCPress.<br />

5. Jaffe ES, Harris NL, Stein H, Vardiman JW, eds (2001)<br />

World Health Organization Classification of Tumours.<br />

Pathology and Genetics of Tumours of Haematopoietic and<br />

Lymphoid Tissues, Lyon, IARCPress.<br />

6. Farhi DC, Rosenthal NS (2000) Acute lymphoblastic<br />

leukemia. Clin Lab Med, 20: 17-28, vii.<br />

7. Estey EH (2001) Therapeutic options for acute myelogenous<br />

leukemia. Cancer, 92: 1059-1073.<br />

8. Alcalay M, Orleth A, Sebastiani C, Meani N,<br />

Chiaradonna F, Casciari C, Sciurpi MT, Gelmetti V, Riganelli<br />

ST-571, α-interferon and arabinosyl cytosine,<br />

a chemotherapeutic agent, can produce<br />

complete cytogenetic remissions, prevention<br />

of blastic transformation and significant<br />

prolongation of survival, with a small<br />

fraction of patients being cured. However,<br />

the development of resistance to ST-571<br />

may cause patients to relapse within a few<br />

months [14]. Without treatment, the life<br />

span for the average individual with chronic<br />

lymphocytic leukaemia is under five<br />

years from diagnosis. The treatment for<br />

this disease historically was with alkylating<br />

agents. Recently the purine antimetabolite,<br />

fludarabine, has substantially increased the<br />

frequency and the quality of response to<br />

chemotherapy. A new monoclonal antibody<br />

directed against the T-cell antigen, CD52<br />

D, Minucci S, Fagioli M, Pelicci PG (2001) Common themes<br />

in the pathogenesis of acute myeloid leukemia. Oncogene,<br />

20: 5680-5694.<br />

9. Faderl S, Talpaz M, Estrov Z, Kantarjian HM (1999)<br />

Chronic myelogenous leukemia: biology and therapy. Ann<br />

Intern Med, 131: 207-219.<br />

10. Keating MJ, O'Brien S (2000) Conventional management<br />

of chronic lymphocytic leukemia. In: Foa R,<br />

Hoffbrand, AV eds, Reviews in Clinical and Experimental<br />

Haematology, 118-133.<br />

11. Brenner MK, Pinkel D (1999) Cure of leukemia. Semin<br />

Hematol, 36: 73-83.<br />

12. Pui C-H, Campana D, Evans WE (2001) Childhood<br />

acute lymphoblastic leukaemia - current status and future<br />

perspectives. Lancet Oncology, 2: 597-607.<br />

13. Kantarjian HM, O'Brien S, Smith TL, Cortes J, Giles FJ,<br />

Beran M, Pierce S, Huh Y, Andreeff M, Koller C, Ha CS,<br />

Keating MJ, Murphy S, Freireich EJ (2000) Results of treatment<br />

with hyper-CVAD, a dose-intensive regimen, in adult<br />

acute lymphocytic leukemia. J Clin Oncol, 18: 547-561.<br />

14. McCormick F (2001) New-age drug meets resistance.<br />

Nature, 412: 281-282.<br />

(“CAMPATH”), has been found to be highly<br />

effective in this disease. At the present<br />

time, combinations of antimetabolite, alkylating<br />

agents and monoclonal antibody in<br />

various combinations and sequences are<br />

being aggressively investigated and the<br />

prognosis for patients in this category of<br />

disease has substantially improved.<br />

Generally, 60-70% of patients with acute<br />

lymphoblastic leukaemia, and 20-30% of<br />

patients with acute myeloid leukaemia (Fig.<br />

5.118) survive in excess of five years.<br />

Approximately 30-50% of the patients diagnosed<br />

with chronic leukaemias survive five<br />

years. Survival is much poorer in developing<br />

countries (generally

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