Recent Trends in the Treatment and Prognosis of Adult Leukemia with Characteristics of Patients in Japan: Transition during the Fifteen Years from 1971 to 1985

: Patients with acute (2,569) and chronic (957) leukemia diagnosed at 19 institutes took part in the study on the "Multidisciplinary Treatment of Leukemia" between 1971 and 1985 and were investigated retrospectively. By dividing the 15 years into three five-year periods, we were able to compare patient ratios in the different periods. The proportions of acute to chronic leukemia cases showed no obvious change; however, the proportions of cases diagnosed as acute lymphocytic leukemia in acute leukemia showed a significant increase. The main chemotherapeutic drugs used during the three time periods were cytarabine or its analogues, the anthracyclines, 6-mercaputopurine and prednisolone, against acute myelogenous leukemia, and the vinca alkaloids, prednisolone and the anthracyclines against acute lymphocytic leukemia. The rate of complete remission from acute myelogenous leukemia made marked progress, from 45.1% during 1971-1975 to 62.3% during 1981-1985, but that of acute lymphocytic leukemia showed no significant progress, being 65% during 1971-1975 and 69.7% during 1981-1985. The durations of remission, however, and the survival times for patients with acute lymphocytic leukemia, as well as for those with acute myelogenous leukemia, became significantly longer over the three periods. Median survival times from chronic myelocytic leukemia were 37-40 mo in all three periods, showing no progress. There was a better prognosis in cases of chronic myelocytic leukemia with, than without, Philadelphia chromosome. Except for a low incidence of chronic lymphocytic leukemia in Japan, adult leukemia patients' characteristics and prognoses seem to be almost the same in Japan as in the U.S.A. and Europe.