CLINICAL AND PATHOLOGIC DIFFERENTIATION OF THE ACUTE LEUKEMIAS

Friedreich 1 in 1857 reported a case of leukemia with an acute course. Ebstein 2 in 1889 described the clinical picture of acute leukemia. Fraenkel 3 in 1895 directed attention particularly to changes in the cells of the blood, and expressed the view that all acute leukemias were lymphogenous because of the similarity of the white blood cells of these patients to lymphocytes. Naegeli 4 in 1900 described the myeloblast, thereby permitting, on the basis of the cytologic characteristics, the separation of two types of acute leukemia, myeloblastic or acute myelogenous and lymphoblastic or acute lymphatic. A sharp differentiation, however, was not always clear owing to difficulties in technic of staining blood smears and because of atypical cases which defied classification. Further elucidation of the problem was forthcoming in the discovery by Reschad and Shilling-Torgau 5 in 1913 of a third type of acute leukemia, acute monocytic leukemia. Although twenty