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The objective of the treatment of acute leukemia involves the eradication of all neoplastic cells, including the last one. Ideally, treatment should be controlled by monitoring cell kill. If the last cells could be discovered and their biological properties be determined, the qualitative and quantitative effects of treatment should be directly evaluable. This should ultimately permit a calculated tumor cell reduction thereby avoiding overtreatment and excessive toxicity and thus providing a basis for individualized antileukemic treatment. In recent years several new developments have contributed to the selective discovery of minimal numbers of leukemic cells which are hidden among the normal cells in the marrow cavities. These methods are the first steps to the realization of the therapeutic goals indicated above. They include the production and ap­ plication of monoclonal antibodies against differentiation antigens on the cell sur­ face, the use of pulse cytophotometry - and cell sorter techniques, the employment of cytogenetics, the development of culture techniques for selective growth of precursor cells and several others. These methodologies offer prospects for refined diagnosis and, as far as the elimination of leukemic cells is concerned, the further development of autologous bone marrow transplantation. Eliminating tumor cells from autologous grafts requires the detailed knowledge of the cellular inter­ relationships within the neoplasm so that the neoplastic cells responsible for tumor propagation are specifically removed. Recognition and characterization of the clonogenic cells of the neoplasm should then lead to determining their sensitivity to the therapeutic agents which are clinically applied.

Relapse of leukemia following successful remission-induction therapy remains a major obstacle in the treatment of patients with acute leukemia. Leukemia recurs most frequently in patients with acute myeloblastic leukemia (AML) and high risk acute lymphoblastic leukemia (ALL) following chemotherapy and less often in patients with low risk ALL and particularly in patient groups> submitted to allogeneic marrow transplantation.'It is likely that the great majority of these recurrences originate from residual leukemic cells that survive initial remission-induction chemotherapy. Today, several research groups throughout the world place emphasis on studies concerned with the detection and treatment of'minimal residual disease'(MRD). These investigations are conducted with the common objective to tackle the remaining cells.'Minimal Residual Disease in Acute Leukemia: 1986'summarizes the fast advancements in this area. Several disciplines are concerned with the analysis of leukemic cells. The perspectives of cytogenetic and molecular genetic approaches for applica­ tion in the detection of MRD are reviewed. In this respect, modern cyto­ genetics provide highly specific tumor markers. The resolution of cyto­ genetic methods can be particularly improved when combined with other techniques which select relevant subpopulations of cells. Characterization of oncogenes and gene rearrangements, including those of immunoglobulin and T-cell receptor genes, and the measurement of gene products, have been established. Techniques based on these approaches offer interesting tools for the detection of MRD. New possibilities of employing monoclonal anti­ bodies are also presented.

Despite significant progress in the treatment of head and neck cancer using new techniques, including organ preservation strategies, recurrence still occurs in up to 50% of patients with locally advanced disease. Head and Neck Cancer Recurrence is the first comprehensive, evidence-based reference on this complex condition, providing state-of-the-art strategies for treating and managing recurrence at each site within the head and neck. With this book at hand, specialists will have guidelines for detecting the presence of a tumor, evaluating the extent and likelihood of successful salvage, determining the most effective treatment modalities, and assessing the potential impact on outcome and function.Special features:Brings together all the current evidence and expertise on the epidemiology, risk factors, clinical and imaging evaluation, and management of recurrent head and neck cancer tumorsIncludes both curative and palliative approaches, and discusses surgical, radiotherapeutic, and chemotherapeutic strategic options Contains substantial contributions by specialists in speech and language therapy, palliative care, psychology, epidemiology, and clinical cancer nursing to provide a holistic, multidisciplinary approach to the management of recurrence of head and neck cancers Brings the decision-making process to life with illustrative case studies that contain patient histories, clinical findings, treatment planning, and documented resultsThe combination of the most recent clinical advances with the latest thinking in the field makes this book an essential resource for all head and neck surgeons, clinical oncologists, radiation oncologists, nurse practitioners, allied health professionals and senior trainees working to improve patient management and outcomes in this challenging arena.