Abstract
52% (11/21) of our children with ALL in marrow remission for >4 years had been classified as “high risk” because of WBC > 30,000/mm3 and/or age < 2 or >7 years at diagnosis. Because of the surprisingly high percentage of “high risk” patients among our long-term survivors, we retrospectively studied 61 children with ALL followed for 2 - 12 years post-diagnosis, to determine whether there was a limited interval during which these unfavorable indicators were operative. 24 patients with WBC>30,000/mm3 had shorter first remissions, a shorter mean survival time and there were fewer survivors at 2 years (p<.005 for each). After 2 years, high initial WBC had no significant predictive value (p > .3). Survival in 14 patients with unfavorable age at diagnosis at no time differed significantly from those of favorable age.
There was no correlation between WBC and frequency of CNS leukemia; but 64% (p<.1) of CNS relapses occurred in the “high risk” age group, 2/3 within 2 years of diagnosis.
We conclude that: 1) the initial WBC is a valid predictor of survival for 2 years after diagnosis, but is invalid if survival exceeds 2 years; and 2) unfavorable age at diagnosis predisposes to CNS relapse in the first 2 years.
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Dunn, N., Mcwilliams, N. & Maurer, H. INSIGNIFICANCE OF PROGNOSTIC INDICATORS AFTER 2-YEAR SURVIVAL IN ACUTE LYMPHOBLASTIC LEUKEMIA (ALL). Pediatr Res 11, 470 (1977). https://doi.org/10.1203/00006450-197704000-00603
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DOI: https://doi.org/10.1203/00006450-197704000-00603