Leukemias and plasma cell dyscrasias

Abstract

This review details major new observations in the diagnosis and treatment of leukemias and plasma cell dyscrasias that have been communicated since the last version of this work. This review is not exhaustive and may appear to some to be rather superficial. However, it should serve as an accurate index of current thinking and accomplishments. The review clearly demonstrates a trend away from traditional chemotherapeutic approaches to the leukemias and related diseases in favor of the more rational design of treatments for specific diseases based on laboratory observations. Some refer to the agents that have resulted from such an approach as targeted therapy and suggest that they represent a new era in cancer treatment, although one of the first targeted therapy agents to be conceived, synthesized and tested was 6-mercaptopurine decades ago. Furthermore, there is no cancer therapy more targeted than surgery, which has been practiced longer than any of us has lived. At any rate, whatever slogan may be used to describe current cancer treatment, it is clear that it is based on more preclinical science and more rational design than ever before. This chapter demonstrates that is certainly true for the leukemias and plasma cell dyscrasias. What has not been demonstrated yet is that better rationale has led to better results. That remains to be proven or disproven by continued observation of our treated patients.