Retrospective Analysis of 158 Cases of Adult Acute Leukaemia: Factors Influencing Prognosis and Treatment Response

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Abstract
Discriminant and regression analyses were employed to determine the influence of a large number of clinical and laboratory indices on outcome of treatment in a series of 158 [human] adults presenting with acute leukemia between 1970-1977. Induction therapy had been most commonly cytosine arabinoside plus daunorubicin, vincristine and prednisolone. This induced complete remission in 42% of nonlymphoblastic and in 58% of lymphoblastic plus undifferentiated leukemias. Some induction failures who had nonlymphoblastic leukemia were treated with cytosine arabinoside plus 6-thioguanine which induced remissions in 46%. Advanced age was the factor most strongly associated with failure to achieve or to sustain complete remission. Thrombocytopenia, promyelocytic leukemia, high percentage of marrow blasts and absence of metaphases in marrow cytogenetic preparations were also associated with poor survival. A number of other factors which appeared to be associated with poor prognosis were found by the analysis to lack significance as independent variables.