Some pharmacologic considerations concerning the control of acute leukemia.

Studies on the mode of action of the presently useful anti-leukemic drugs describe the metabolic features of leukemic lymphoblasts which serve as a basis for killing these cells selectively. Individually, these agents are inadequate in most cases to maintain prolonged remissions. The combined use, however, of drugs which act differently has the potentiality of greatly increasing the selectivity of treatments and minimizing the development of drug resistance. In anticipation of the discovery of more effective drugs which may displace these, or the utilization of new information about regulatory macromolecules, amplification of the effectiveness of the presently useful agents can be attempted, in the manner discussed, with the information de rived from studies of a physiologic regulator (cortisol), a pseudo-feedback inhibitor (6-mercaptopurine), and a vitamin antagonist (amethopterin).