A mathematical model of the chemotherapeutic treatment of acute myeloblastic leukemia.

Based on our previous mathematical model of the acute myeloblastic leukemic (AML) state in man, we superimpose a chemotherapeutic drug treatment regimen. Our calculations suggest that small changes in the protocol can have significant effects on the result of treatment. Thus, the optimal period between drug doses is the S-phase interval of the leukemic cells--about 20h--and the greater the number of doses administered in a given course treatment, the longer the rest interval should be before the next course is administered. For a patient with a "slow" growing AML cell population, remission can be achieved with one or two courses of treatment, and further suppression of the leukemic population can be achieved with continued courses of treatment. However, for patients with a "fast" growing AML cell population, a similar aggressive treatment regimen succeeds in achieving remission status only at the cost of very great toxic effects on the normal neutrophil population and its precursors.