This book provides an overview of the key developments in both acute lymphocytic leukemia and acute myeloid leukemia with a comprehensive guide to the epidemiology, pathogenesis, etiology, clinical manifestations, classification, diagnosis, and staging as well as the most recent developments in the therapeutic landscape for acute leukemia. The Handbook of Acute Leukemia offers readers a key resource into the future outlook for patients with leukemia and is edited and authored by internationally renowned experts in the field. Leukemia is cancer of the white blood cells and acute leukemia means the condition progresses rapidly and aggressively, requiring immediate treatment. Acute leukemia is classified according to the type of white blood cells that are affected: either lymphocytes and myeloid cells.

150 years after the first description of the clinical picture of "white blood" and the introduction of the term "leukemia" by R. Virchow it appears, that the leukemias, and the acute leukemias in particular, serve as an impressive example for the major improvements that have been achieved in the treatment but also in the understand ing of the biology of malignant dis orders. The international symposia "Acute Leukemia" which are held at Munster since 1986 have developed into an interna tional forum to review the current progress and the future perspectives of leukemia research and therapy at a high scientific and clinicallevel. Since the possibility for active participation in these symposia is somewhat restricted we are glad to have the opportunity to extend the information that was presented at the symposium "Acute Leukemias V - Experimental Approaches and Management of Refractory Disease" which was held from February 27 to March 2, 1994 to a broader audience of basic scientists and clinicians. This meeting was especiaIly designed to discuss experimen tal approaches and the management of refractory disease which allows to evaluate new experimental therapies on the basis of preclinical studies."

The 6th volume of the book series Acute Leukemias presents both therapeutic and prognostic updates of the most recent results of major multicenter clinical trials. Additional chapters report on new trends in leucemia cell biology, the monitoring of minimal residual disease and secondary leucemias as well as new antileucemic drugs, antimicrobial strategies and the use of cytocines. Acute Leukemias VI provides a new update on the rapid progress being made internationally concerning leucemic diseases.

Acute leukemia a quite homogenous disease failed to break through the sound barriere of when untreated reveals a substantial hetero unsatisfactory cure rates even in special sub geneity in its response to therapy. While cure groups. While new protocols including more is achieved in a certain proportion of pa effective supportive care show some increase tients other cases prove to be highly resis in the initial response rates and certain im tant. The curability is superior in acute provements in the long-term results, no ben lymphoblastic (ALL) than in acute myeloid eficial effect on the relapse rate during the (AML) leukemia and - within both type- first 1 Y2 years emerged from any of these higher in children as compared to adults. regimens. Thus, high chances for cure are The two age groups and cell types can be presently restricted to children with ALL further subdivided into prognostic groups and to lesser proportions children with by special diagnostic features. Thus, in AML and adults with ALL and AML.

Chromosome abnormalities of cancer cells have been recognized for a long time, and have generally proven to be a highly specific marker ofmalignancy. The contri- butions collected in this book, "Tumor Aneuploidy", cover several major aspects of present knowledge conceming the occurrence and clinical significance of chromo- some abnormalities as delineated by karyotype analyses or measurements of the cellular DNA content. Certain non-random clonal chromosome losses, deletions and translocations ap- pear to represent primary genetic lesions of malignancies and reflect their clonal origin. Secondary intraneoplastic genetic evolution is suggested by major clonal ab- normalities of chromosome number and cellular DNA content. Both types of ge- netic changes have been reaching great relevance in cancer medicine, today. Although the Philadelphia chromosome was first discovered in chronic myelo- cytic leukemia (CML), by Nowell and Hungerford in 1960, new banding techniques developed in the 1970's were needed to identity this abnormality as a translocation between chromosomes 9 and 22 (t(9; 22)). Soon thereafter, further non-random translocations were detected and attributed to special diseases like t(8; 21) and t(15; 17) to acute myeloid leukemias (AML) and t(9; 22), t(4; 11), t(8; 14) to acute lymphoblastic leukemia (ALL).