Case of Myeloid Leukemia Treated with Luminal and Amidopyrine

On September 15, 1933, a male negro 37 years old was admitted to the medical service with the diagnosis of myeloid leukemia. His leucocyte count was 267,000 per cu. mm. and his spleen came to the level of the umbilicus.

Four treatments by splenic irradiation in doses of 145 r, beginning October 6, brought the count down to 156,000. This effect was transitory; on November 21 the count was 269,000 and there was no reduction in the size of the spleen.

From November 21 to March 7, 1934, the patient was given subcutaneous injections of his own leucocytes, each injection consisting of the cells recovered from 10 cc. of his blood taken in citrated salt solution the day before injection. This treatment, based on an encouraging report by Lindstrom 1 and previously used by one of us (M.C.T.) with apparent benefit in 2 unpublished cases, was without avail in the case here reported, the count continuing to rise until, on March 7, it was 500,000 with the spleen as large as before.

Beginning March 8 four small doses of X-ray irradiation (72 r) were given over the chest and long bones. The irradiation of March 30 was immediately preceded by the last of the leucocyte injections, the rays being directed to the injected area. Under this treatment the count declined to 160,000 but on March 31 it had risen to 294,000. The last X-ray treatment was given April 6.

At this time reports were appearing of cases of granulopenia apparently due to the use of luminal and amidopyrine and it occurred to us that this combination of drugs might be of value in the treatment of myeloid leukemia, with its enormous increase of cells of the granular type. Accordingly we gave our patient a total of 6 grains of luminal and 20 grains of amidopyrine in 4 doses from April 11 to April 13. We repeated these drugs in the same quantities beginning May 2 and again beginning May 9. Beginning May 14 we gave 6 grains of luminal and 20 grains of amidopyrine daily for 4 days.