Prognostic factors for relapse-free survival in childhood acute lymphoblastic leukaemia

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Abstract
11 variables determined at the onset of acute lymphocytic leukemia were tested to predict disease-free survival in 267 children. All children had received similar induction treatment and basic maintenance therapy, whereas 5 different reinforcement treatments were administered irrespective of the severity of the disease at onset. Three modes of prophylactic CNS treatment were employed. The risk of relapse was significantly increased for leukeocyte count above 50 .times. 109/1, lymphoblasts above 80% in peripheral blood, age below 2 yr or over 5 yr, and for males. The risk of relapse was increased by estimated factors of 1.9, 2.3, 1.7 and 1.7, respectively. When the above 4 variables were included in the model, no further prognostic value was demonstrated for Hb concentration, platelet count, signs of bleeding in the skin, mucous membranes or intracranially, presence of leukemic infiltrations outside the bone marrow, hepatosplenomegaly, mediastinal mass, or T- or B-cell leukemia. Evaluation of T- or B-lymphoblast type impact was hampered by small numbers.