Not long ago, treating acute leukemia meant using a "cookbook" approach: With no well defined prognostic factors, all patients were likely to receive a standard therapy of an anthracycline (such as daunorubicin) combined with vincristine sulfate, prednisone, and either cytarabine or asparaginase. Now some specific pretreatment "markers" that indicate prognosis allow physicians to tailor therapy to individual patients.
"We don't want to give aggressive therapy to a patient with a good chance of response to conventional therapy," explained Kenneth B. McCredie, MB, BS, professor of medicine and deputy head of the Department of Developmental Therapeutics at the M.D. Anderson Hospital and Tumor Institute at the University of Texas System Cancer Center, Houston. "Our aim is to individualize therapy."
At M.D. Anderson, McCredie and co-workers have already started achieving this aim. Using a number of pretreatment factors such as presence or absence of infection or level of serum creatinine, they can