Leukemia is a fairly common blood dyscrasia characterized by unrestrained overgrowth of tissues which normally form leukocytes, as well as by areas of leukopoietic proliferation in other parts of the body. There is much to indicate that it is a neoplastic disease. Although the length of life of patients with leukemia varies greatly, the disease always ends fatally. Different types of leukemia may present such widely varying clinical pictures that many diseases are suggested.
During the past thirteen years 357 patients with leukemia have been studied in the Cleveland Clinic. Detailed blood studies in all cases were made in the hematology laboratory, and bone marrow preparations were studied when indicated. When a blood examination shows a definite leukemia, a bone marrow film only confirms the diagnosis; but when the diagnosis from the blood examination is difficult because of leukopenia or a scarcity of immature cells, the marrow findings may be diagnostic. All blood and marrow preparations are kept in a permanent file for review.
The exact distribution of the 357 cases according to the five types of leukemia is as follows: monocytic 52, acute myeloid 60, chronic myeloid 90, acute lymphoid 54, chronic lymphoid 101.
I analyzed in detail 250 of the 357 case histories, or 50 consecutive cases of each of the five types. In this survey almost all the monocytic, the acute myeloid, and the acute lymphoid cases were included. Consecutive cases of chronic myeloid and chronic lymphoid leukemia were taken to insure a fair sample.
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