The clinical features, cytogenetics and response to treatment have been examined in 180 infants (aged <1 year) with acute leukaemia; 118 with acute lymphoblastic leukaemia (ALL) and 62 with acute myeloid leukaemia (AML). Comparison of clinical features showed no difference in age or sex distribution between infants with ALL and AML but infants with ALL tended to have higher leucocyte counts at presentation. Cytogenetic abnormalities involving 11q23 were found in 66% of ALL and 35% of AML cases, the commonest, t(4;11) being found only in ALL. The other recognised 11q23 translocations were found in both types of leukaemia. Few patients had the common cytogenetic abnormalities associated with ALL in older children and few with AML had good risk abnormalities. Four year event-free survival 60% cf 30% (P = 0.001) and survival 65% cf 41% (P = 0.007) were significantly better in AML than ALL. These results were due to a lower risk of relapse 27% cf 62% at four years. Superior event-free survival was also seen in the subgroup of patients with 11q23 abnormalities and AML (55% cf 23%). The reasons for superior response in AML are unknown but may be related to the intensity of treatment, lineage of the leukaemia or other as yet unidentified factors.
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JM Chessells and H Kempski are supported by the Leukaemia Research Fund. The cytogenetics databases for ALL and AML are supported by the Leukaemia Research Fund and the Kay Kendall Leukaemia Fund. The authors wish to thank the following UK cytogenetics laboratories for providing their cytogenetic results: Belfast; Birmingham; Bristol; Cardiff; Edinburgh; Glasgow; Leeds; Liverpool; Royal Free, Royal Marsden, St Batholomew's Hospitals, London; Christie Hospital Manchester; Newcastle; Nottingham; Oxford; Salisbury; Sheffield.
Appendix: Members of the MRC Childhood Leukaemia Working Party
Appendix: Members of the MRC Childhood Leukaemia Working Party
Bailey CC, Barton C, Broadbent V, Caswell M, Chessells JM, Darbyshire PJ, Dempsey SI, Durrant J, Eden OB (past chairman), Gibson B (chairman), Goodman A, Gray R, Hann I, Harrison C, Haworth C, Forman K, Hill FGH, Jenney M, Kernahan J, King DJ, Kinsey SE, Madden M, Mann JR, Martin J, Meller ST, Mitchell C, Oakhill A, Radford M, Reid MM, Richards SM, Smyth O, Stevens RF, Thomas A, Vargha-Khadem F, Vora AJ, Walker D, Webb D, Wheatley K, Will A, Windebank K.
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Chessells, J., Harrison, C., Kempski, H. et al. Clinical features, cytogenetics and outcome in acute lymphoblastic and myeloid leukaemia of infancy: report from the MRC Childhood Leukaemia working party. Leukemia 16, 776–784 (2002). https://doi.org/10.1038/sj.leu.2402468
- acute leukaemia
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