Ⅰ.LEUKEMIA IN THE PAST 1
Ⅱ.DEFINITION 12
Ⅲ.CLASSIFICATIONS 15
Ⅳ.THE PREVALENCE OF LEUKEMIA 27
Definitions 27
Sources of Information 28
Geographical, Racial and Social Distribution 29
Total Prevalence 31
Type Distribution 31
Age Distribution 36
Sex Distribution 37
Is There a Rising Incidence of Leukemia? 39
Ⅴ.THE ETIOLOGY OF LEUKEMIA 44
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 Disease 47
Other Views on the Nature of Leukemia 50
Infection 51
“Metabolic” or“Toxic” 58
Leukemogenic Factors 62
Heredity， 62
Hormones， 66
Radiation， 66
Benzol, 75
Ⅵ.THE PATHOLOGY OF THE LEUKEMIC CELL 86
Development 80
Morphology 93
Chemistry 99
Carbohydrate Metabolism 105
Life Span of Leukocytes 106
In Vitro Studies of Leukocytes 108
Recapitulation and Outlook 109
Ⅶ.COURSE AND SPECIAL PATHOLOGY AS RELATED TO SYMPTOMATOLOGY 118
Clinical Manifestations 118
The Onset 119
The Early Physical Findings 122
The Further Course 124
Special Pathology and Pathologic Physiology of Leukemia, Particularly in the Later Stages 126
Hematopoietic and Lymphatic Organs 126
Involvement of the Bones and Joints 130
Chloromas 135
Involvement of the Nervous Sys-tem 138
Involvement of the Skin 141
Involvement of the Gastrointes-tinal Tract 143
Involvement of the Heart 145
Involvement of the Mouth and Respiratory System 147
Mikulicz’s Syndrome 149
Involvement of the Retina 149
Involvement of the Kidneys 151
Pria-pism in Leukemia 151
Pregnancy in Leukemia 152
Ⅷ.CLINICAL DESCRIPTIVE FEATURES 159
The Acute Leukemias 159
Symptoms 159
Signs 159
Course 160
Blood and Bone Marrow 161
The Chronic Leukemias 167
Chronic Granulocytic Leukemia 168
Symptoms and Signs, 168
Blood 168
Course 170
Special Symptoms and Complications 171
Other Types of Granulocytic Leukemia 173
Eosinophilic (Granulocytic) 173
Basophilic (Granulocytic) 177
Mast Cell Leukemia 179
Chronic Lymphocytic Leukemia 179
Symptoms and Signs 179
Disorders of the Serum Proteins 186
The Blood Picture 187
Course 188
Multiple Myeloma (Chronic Plasmocytic Leukemia) 189
Pathologic Physiology, 189
Clinical Course, 201
Congenital Leukemia 202
Ⅸ.SPECIAL FEATURES 206
The Anemia 206
The Hemorrhagic State 215
Platelet Disturbances:Thrombocytopenia;“Thrombocytopathy,” 216
Other Factors 216
Certain Metabolic Aspects 218
Purine Metabolism, 219
The Basal Metabolic Rate, 221
Serum Pro-tein Abnormalities 222
Immunologic Abnormalities 226
Auto-immune Hemolytic Anemia 227
Leukocytic Antibodies 228
Platelet Antibodies 229
Ⅹ.DIFFERENTIAL DIAGNOSIS 234
Clinical Diagnosis 234
Laboratory Diagnosis 237
Ⅺ.THE LABORATORY DIAGNOSIS OF LEUKEMIA 243
Examination of the Blood 243
Acute Leukemia 243
Chronic Leukemia 247
Summary of Blood Find-ings 249
Examination of the Bone Marrow 250
Splenic Puncture 253
Examination of the Lymph Nodes (Puncture; Biopsy) 256
An Appraisal of the Relative Value of the Various Hematologic Investigations in Cases of Leukemia 258
Ⅻ. LEUKEMIA AND THE “MYELOPROLIFERATIVE”DISORDERS 262
Chronic Myeloproliferative Disorders 264
Myelosclerosis and Myeloid Metaplasia 264
Polycythemia Vera, and Its Relationships to Myelofibrosis and Leukemia 271
Thrombocythemia 277
The Acute Myeloproliferative Syndromes 278
The Di Guglielmo Syndrome; Relations to Myelosclerosis and to Polycythemia 278
Relationships of Leukemia and Polycythemia Vera to Other Hematologic Conditions 291
Leukemia, Tuberculosis and Carcinomatosis 292
ⅩⅢ.THE PROGNOSIS OF LEUKEMIA 298
Difficulties in Prognosis 298
Ways of Expressing the Prognosis 300
The Over-all Prognosis in Untreated Leukemia 301
The Prognosis in Individual Cases 304
The Influence of Treatment on the Prognosis 306
ⅩⅣ.WHAT SHOULD ONE TELL THE PATIENT! 311
ⅩⅤ.THE TREATMENT OF LEUKEMIA 314
Introductory 314
Mode of Action and Clinical Uses of Therapeutic Agents in Leukemia 318
Ionizing Radiations 319
Mechanism of Action of Ionizing Radiations on the Blood Cells 319
Mode of Therapeutic Action of Ionizing Radiations in Leu-kemia 321
Clinical Use of Ionizing Radiations 325
Chemotherapy 327
The Nitrogen Mustards (Alkylating Agents) 329
Other Alkylating Agents 333
Mustard Derivatives 334
Ethyleneimino Compounds 335
My-leran 336
Clinical Uses of the Alkylating Agents 337
The Colchicine Group 338
Agents with Uncertain Mode of Action 339
Arsenic 340
Benzol 340
Urethane 340
Aromatic Diamidines 342
Others 343
Antivitamins and Antimetabolites 343
Folic Acid Antagonists 345
Purine Antagonists 348
Amino Acid Analogs 350
Clinical Use of Antivitamins and Antimetabolites 351
General Note on the Various Anti-mitotic and Cytostatic Agents 351
Other Forms of Therapy 352
Cortisone and ACTH 352
Symptomatic Therapeutic Agents and Their Clinical Uses 355
Splenectomy 356
No Therapy 356
Summary 356
Management of the Different Forms of Leukemia 371
Acute Leukemia 371
In Childhood 371
In Adults 375
Chronic Leukemia 379
Chronic Granulocytic Leukemia 380
Chronic Lymphocytic Leukemia 388
Multiple Myeloma 393
ⅩⅥ.LEUKEMIA.IN THE FUTURE 398
INDEX 411