Influence of chemotherapy on pathology,complication and death in patients with acute leukemia-Clinical and pathological analysis of 60 cases

The autopsy data of 60 patients with acute leukaemia were analysed.Patients were divided into three groups according to the difference in therapy and response.Group 1 consisted of 16 cases receiving no chemotherapy what so ever;group 2 was formed by 27 cases having received chemotherapy but failed to achieve remission;the remaining 17 cases made up the third group in which chemotherapy was given and remission was achieved,The frequency of leukemic infiltration in hemopoitic organs was similar in group Ⅰ and 2,being highter in both groups than that in group 3;but the frequency of leukemic infiltration in central nervous system,testes,and ovaries was higher in group 3,suggesting the possible sources of leukemic recurrence.The frequency of complicating infection was highest in group 3（88.2%）,as compared with 70.3% and 31.2% in group 2 and group 1 respectively.The most frequent direct cause of death was hemorrhage in group 1（56.2%）and infection in group 3（52.9%）.The occurrence of deep mycosis was definitelv higher in group 2 and 3,with an inciedne of 44.8% and 55.4% of infection respectively,higher than that of bacterial infection on pathological examomatopm.Almost no leukemic infiltration could be identified in 1/3 patients of group 3 died of infection. The pressent analysis reveals a close relationship between chemotherapz and complicating infections and emphases the importance of a good knowledge of the principles of chemotherapy and its judicious use.