Donald Pinkel, chairman of the Dept. of Pediatrics at the Medical College of Wisconsin, was quoted incorrectly in The Cancer Letter (April 7) report on his Karnofsky lecture at the American Society of Clinical Oncology meeting. The report said that studies cited by Pinkel had found that the addition of second, third and fourth drugs in treating acute lymphocytic leukemia produced no better results than single drug therapy.
“In the Karnofsky lecture at ASCO I indicated that in our St. Jude Study VIII the patients receiving two drugs (mercaptopurine and methotrexate) had better remission experience than those receiving one drug (methotrexate alone),” Pinkel wrote. “However, the addition of a third (cyclophosphamide) and of third and fourth drugs (cyclophosphamide and arabinosyl cytosine) did not improve remission duration or the frequency of lengthy remission. Thus, two drugs are superior but not three or four drugs. Morbidity was least for the two drug group.”
Pinkel also felt that another item in The Cancer Letter report “is open to misinterpretation.” Referring to his statement concerning the prospect that 50% of ALL patients can be cured, the report said, “The half who are being cured are those who receive the optimal treatment in the most advanced facilities.” Pinkel was quoted as saying, “Most children with the disease around the world do not benefit from these advances. The treatment is too complex and is not accessible to them.”
To correct any misinterpretation, Pinkel wrote, “One-half of those who receive optimal treatment are apparently being cured, but worldwide the vast majority of children do not receive optimal treatment so that the worldwide apparent cure rate is much lower.”