Short-Term In Vitro Sensitivity Testing in Acute Leukemia

Abstract

The treatment of acute leukemia with highly cytotoxic drug regimens has made well-planned protocols necessary in order to avoid undue exposure of the patients. It has therefore become more and more desirable to find determinant initial factors related to possibly good or poor responses of the patients to cytostatic therapy. Numerous investigators have attempted to establish such factors and have stressed the role of pretreatment cytokinetics, leukemic cell mass, cytologic criteria, chromosomal aberra­tions, etc. Previous studies in our laboratory have emphasized the predictive implications of cyclic adenosine monophosphate in leukemic cells and have reconfirmed the prognostic value of proliferation kinetics (Paietta et al. 1980). A more direct approach to detect sensitivity of leukemic blast cells, however, is their in vitro exposure to specific chemotherapeutic agents and the determination of reliable parameters of cell viability (Dow 1980; Preisler 1980; Spiro et al. 1981; Von Hoff and Weisenthal 1980; Weisenthal 1981). Since the course of the disease in patients with acute leukemia very often requires prompt therapeutic decisions, the application of short-term tests seems to be more feasible than the use of time-consuming but perhaps more sensitive assays. We therefore investigated the in vitro effect of various cytostatic agents on the incorporation of nucleoside precursors into leukemic blast cells and correlated the in vitro results with the clinical response of the patients to chemotherapy.

Supported by the Fonds zur Förderung der wissenschaftlichen Forschung in Austria, Project No. 4782