The Impact of Treatment on the Natural History of Acute Leukemia

Abstract

The disease leukemia has been an important disease for the understanding of human malignancy. The primary reason for this is that it has been recognized almost from the time the disease was described that it is systemic from the outset and has no local presentation. As a result, it has been a prototype disease for the understanding of the biology of widespread, metastatic, systemic cancer (1). I have always felt that the clinical scientist has the opportunity to conduct basic research. Basic in the sense that it leads to a fundamental understanding of biology which almost certainly could not be observed by the laboratory scientist. Cancer, as a fundamental problem in biology, shines as an example in support of this contention. Cancer was recognized as a disease in man and further clinical study led to the appreciation that these tumors arose in organs consequently spreading regionally and ultimately systemically. These fundamental clinical observations led to the formulation of cancer biology principles which guided basic research into tumor biology for almost a century.