Organized on behalf of the Deutsche Gesellschaft für Hämatologie und Onkologie. Wilsede, June 21-23, 1982

Organized on behalf of the Deutsche Gesellschaft für Hämatologie und Onkologie, Wilsede, June 21-23, 1982

Organized on behalf of the Deutsche Gesellschaft für Hämatologie und Onkologie. Wilsede, June 17-20, 1984 Wilsede Joint Meeting on Pediatric Oncology III. Hamburg, June 21/22, 1984.

Organized on behalf of the Deutsche Gesellschaft für Hämatologie und Onkologie, Hamburg, June 27/28, 1986

You see things, and sa)' why? But I dream 1hings that never were, and I say, 11'hy 110t? George Bernhard Shaw Far ahead of his time, June 1st, 1909, Alexander Maximov communicated in a lecture, given in the Charite in Berlin, the fundamental knowledge, that there exists a lymphoid hemopoetic stem cell. Alexander Friedenstein explained that during the following years, Maximov also showed that the idea of interaction between hemopoetic cells and their stroma to be one of the most significant experiences. Monoclonal antibodies, recombinant DNA technics and the improvement of tissue culture models are the major developments to improve our possibilities to clarify growth and differentiation functions of hemopoetic cells. During the last two decades it was shown that soluble products, released from T cells, were not only involved in inducing B cells to produce specific immunoglobulin secretion after antigen stimulation. Furthermore, lymphokines together with other cytokines regulate the growth and differentiation of hemopoetic cells. As I have learned from Dick Gershon, our knowledge of the cellular basis for immunoregulation has come a long way since 450 B.C. Thucydides comments on the possible role of immune response in controlling the Black Death. Dick Gershon speculated that no scientific interest for these interesting observations was put forth at that time. Perhaps the problems, the Athenians were having with the Spartans, converted money from basis research into the military budget.

This book provides a comprehensive and up-to-date review of all aspects of childhood Acute Lymphoblastic Leukemia, from basic biology to supportive care. It offers new insights into the genetic pre-disposition to the condition and discusses how response to early therapy and its basic biology are utilized to develop new prognostic stratification systems and target therapy. Readers will learn about current treatment and outcomes, such as immunotherapy and targeted therapy approaches. Supportive care and management of the condition in resource poor countries are also discussed in detail. This is an indispensable guide for research and laboratory scientists, pediatric hematologists as well as specialist nurses involved in the care of childhood leukemia.

''An exciting glance at key issues in contemporary hematopoiesis.'' -The Quarterly Review of Biology

The objective of the treatment of acute leukemia involves the eradication of all neoplastic cells, including the last one. Ideally, treatment should be controlled by monitoring cell kill. If the last cells could be discovered and their biological properties be determined, the qualitative and quantitative effects of treatment should be directly evaluable. This should ultimately permit a calculated tumor cell reduction thereby avoiding overtreatment and excessive toxicity and thus providing a basis for individualized antileukemic treatment. In recent years several new developments have contributed to the selective discovery of minimal numbers of leukemic cells which are hidden among the normal cells in the marrow cavities. These methods are the first steps to the realization of the therapeutic goals indicated above. They include the production and ap plication of monoclonal antibodies against differentiation antigens on the cell sur face, the use of pulse cytophotometry - and cell sorter techniques, the employment of cytogenetics, the development of culture techniques for selective growth of precursor cells and several others. These methodologies offer prospects for refined diagnosis and, as far as the elimination of leukemic cells is concerned, the further development of autologous bone marrow transplantation. Eliminating tumor cells from autologous grafts requires the detailed knowledge of the cellular inter relationships within the neoplasm so that the neoplastic cells responsible for tumor propagation are specifically removed. Recognition and characterization of the clonogenic cells of the neoplasm should then lead to determining their sensitivity to the therapeutic agents which are clinically applied.