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Ⅰ.LEUKEMIA IN THE PAST1

Ⅱ.DEFINITION12

Ⅲ.CLASSIFICATIONS15

Ⅳ.THE PREVALENCE OF LEUKEMIA27

Definitions27

Sources of Information28

Geographical, Racial and Social Distribution29

Total Prevalence31

Type Distribution31

Age Distribution36

Sex Distribution37

Is There a Rising Incidence of Leukemia?39

Ⅴ.THE ETIOLOGY OF LEUKEMIA44

The Nature of Leukemia. Is Leukemia Neoplastic?44

Cytology of Leukemic Cells,45

Relation of Leukemia to Tumors of the Lymphatic and Hematopoietic Systems,45

Leukemia in Animals and Its Relation to Neoplastic Disease47

Other Views on the Nature of Leukemia50

Infection51

“Metabolic” or“Toxic”58

Leukemogenic Factors62

Heredity，62

Hormones，66

Radiation，66

Benzol,75

Ⅵ.THE PATHOLOGY OF THE LEUKEMIC CELL86

Development80

Morphology93

Chemistry99

Carbohydrate Metabolism105

Life Span of Leukocytes106

In Vitro Studies of Leukocytes108

Recapitulation and Outlook109

Ⅶ.COURSE AND SPECIAL PATHOLOGY AS RELATED TO SYMPTOMATOLOGY118

Clinical Manifestations118

The Onset119

The Early Physical Findings122

The Further Course124

Special Pathology and Pathologic Physiology of Leukemia, Particularly in the Later Stages126

Hematopoietic and Lymphatic Organs126

Involvement of the Bones and Joints130

Chloromas135

Involvement of the Nervous Sys-tem138

Involvement of the Skin141

Involvement of the Gastrointes-tinal Tract143

Involvement of the Heart145

Involvement of the Mouth and Respiratory System147

Mikulicz’s Syndrome149

Involvement of the Retina149

Involvement of the Kidneys151

Pria-pism in Leukemia151

Pregnancy in Leukemia152

Ⅷ.CLINICAL DESCRIPTIVE FEATURES159

The Acute Leukemias159

Symptoms159

Signs159

Course160

Blood and Bone Marrow161

The Chronic Leukemias167

Chronic Granulocytic Leukemia168

Symptoms and Signs,168

Blood168

Course170

Special Symptoms and Complications171

Other Types of Granulocytic Leukemia173

Eosinophilic (Granulocytic)173

Basophilic (Granulocytic)177

Mast Cell Leukemia179

Chronic Lymphocytic Leukemia179

Symptoms and Signs179

Disorders of the Serum Proteins186

The Blood Picture187

Course188

Multiple Myeloma (Chronic Plasmocytic Leukemia)189

Pathologic Physiology,189

Clinical Course,201

Congenital Leukemia202

Ⅸ.SPECIAL FEATURES206

The Anemia206

The Hemorrhagic State215

Platelet Disturbances:Thrombocytopenia;“Thrombocytopathy,”216

Other Factors216

Certain Metabolic Aspects218

Purine Metabolism,219

The Basal Metabolic Rate,221

Serum Pro-tein Abnormalities222

Immunologic Abnormalities226

Auto-immune Hemolytic Anemia227

Leukocytic Antibodies228

Platelet Antibodies229

Ⅹ.DIFFERENTIAL DIAGNOSIS234

Clinical Diagnosis234

Laboratory Diagnosis237

Ⅺ.THE LABORATORY DIAGNOSIS OF LEUKEMIA243

Examination of the Blood243

Acute Leukemia243

Chronic Leukemia247

Summary of Blood Find-ings249

Examination of the Bone Marrow250

Splenic Puncture253

Examination of the Lymph Nodes (Puncture; Biopsy)256

An Appraisal of the Relative Value of the Various Hematologic Investigations in Cases of Leukemia258

Ⅻ. LEUKEMIA AND THE “MYELOPROLIFERATIVE”DISORDERS262

Chronic Myeloproliferative Disorders264

Myelosclerosis and Myeloid Metaplasia264

Polycythemia Vera, and Its Relationships to Myelofibrosis and Leukemia271

Thrombocythemia277

The Acute Myeloproliferative Syndromes278

The Di Guglielmo Syndrome; Relations to Myelosclerosis and to Polycythemia278

Relationships of Leukemia and Polycythemia Vera to Other Hematologic Conditions291

Leukemia, Tuberculosis and Carcinomatosis292

ⅩⅢ.THE PROGNOSIS OF LEUKEMIA298

Difficulties in Prognosis298

Ways of Expressing the Prognosis300

The Over-all Prognosis in Untreated Leukemia301

The Prognosis in Individual Cases304

The Influence of Treatment on the Prognosis306

ⅩⅣ.WHAT SHOULD ONE TELL THE PATIENT!311

ⅩⅤ.THE TREATMENT OF LEUKEMIA314

Introductory314

Mode of Action and Clinical Uses of Therapeutic Agents in Leukemia318

Ionizing Radiations319

Mechanism of Action of Ionizing Radiations on the Blood Cells319

Mode of Therapeutic Action of Ionizing Radiations in Leu-kemia321

Clinical Use of Ionizing Radiations325

Chemotherapy327

The Nitrogen Mustards (Alkylating Agents)329

Other Alkylating Agents333

Mustard Derivatives334

Ethyleneimino Compounds335

My-leran336

Clinical Uses of the Alkylating Agents337

The Colchicine Group338

Agents with Uncertain Mode of Action339

Arsenic340

Benzol340

Urethane340

Aromatic Diamidines342

Others343

Antivitamins and Antimetabolites343

Folic Acid Antagonists345

Purine Antagonists348

Amino Acid Analogs350

Clinical Use of Antivitamins and Antimetabolites351

General Note on the Various Anti-mitotic and Cytostatic Agents351

Other Forms of Therapy352

Cortisone and ACTH352

Symptomatic Therapeutic Agents and Their Clinical Uses355

Splenectomy356

No Therapy356

Summary356

Management of the Different Forms of Leukemia371

Acute Leukemia371

In Childhood371

In Adults375

Chronic Leukemia379

Chronic Granulocytic Leukemia380

Chronic Lymphocytic Leukemia388

Multiple Myeloma393

ⅩⅥ.LEUKEMIA.IN THE FUTURE398

INDEX411