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dc.contributor.authorFountain, James R.en
dc.date.accessioned2018-01-31T11:43:59Z
dc.date.available2018-01-31T11:43:59Z
dc.date.issued1956en
dc.identifier.urihttp://hdl.handle.net/1842/28051
dc.description.abstracten
dc.description.abstractSince the recognition of the disease one hundred years ago, the treatment of leukaemia has passed through two main phases. During the first fifty years treatment was by chemical agents. A ,large variety underwent clinical trial and some were found to temporarily influence the leukaemic process. Unfortunately many were highly toxic, and probably on account of this and our ignorance f their mode of action. they became known as cytotoxic agents. The discovery of x -rays in the early part of the Present century led to a new a_Dproach in treatment, and radiotherapy thereafter was generally accepted, by most clinicians, as the treatment of choice for the chronic variety of leukaemia. During the past decade, however, interest has been renewed in chemotherapy, and it seems likely that we are now on the threshold of a second era of chemotherapy. Since the Second World sudar a considerable amount of research in this subject has been carried out in the United Kingdom and the United States of America and to a lesser ;extent in other parts of the world. As a result 1 number of chemical agents have been discovered which materially influence not only patients with chronic leukaemia but also those with the more rapidly fatal acute disease. Their introduction has come about in one of three ways: (a) the observation that a compound being investigated for other reasons has a depressant effect on haemopoietic tissues - for example nitrogen mustard and urethane; (b) the synthesis of compounds related chemically to substances already known to be effective, such as in the case of triethylene melamine, triethylene phosphoramide, and 1:4- dimethanesulphonyloxybutane (Myeleran); and (c) the synthesis of analogues of nucleic acid precursors. Much attention is now being focussed on the last group of compounds. It is an entirely new field of research in chemotherapy and is considered by many investigators to be a more rational approach to the problem. Not only have some, e.g. the folic acid analogues and the purine analogue 6- mercaptopurine, resulted in dramatic 'remissions in patients with acute leukaemia, but with the aid of modern scientific techniques information has been obtained relating to their mode of action In addition their importance as a stimulus to research into biochemical processes connected with nucleic acid metabolism in the normal, leukaemic and neoplastic cell as a whole, probably outweighs their present therapeutic value.en
dc.description.abstractThis thesis contains a study of the advances in chemotherapy which have taken place during the past ten years. For descriptive purposes it has been divided into four main sections. In the first the history of chemotherapy has been described. This is followed by a section devoted to a comprehensive review of modern chemotherapeutic agents available for the treatment of both acute and chronic leukaemia. Allied neoplastic disorders shown to be responsive to these compounds have also been included in the text. A third section describes metabolic studies in normal and leukaemic patients and animals. The metabolism of the folic acid analogue, amethopterin, with particular reference to the problem of drug resistance is principally dealt with. Studies in the metabolism of folic acid and the citrovorum factor are also included. The final section deals with the clinical evaluation, in fifty patients, of a new compound, 6-mercaptopurine.en
dc.publisherThe University of Edinburghen
dc.relation.ispartofAnnexe Thesis Digitisation Project 2017 Block 16en
dc.relation.isreferencedbyen
dc.titleStudy of the chemotherapy of leukaemiaen
dc.typeThesis or Dissertationen
dc.type.qualificationlevelen
dc.type.qualificationnameMD Doctor of Medicineen


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