PRETREATMENT PROGNOSTIC FACTORS AND HOSPITALIZATION PERIODS IN CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA

  • 1 January 1982
    • journal article
    • research article
    • Vol. 18  (4) , 447-455
Abstract
Pretreatment prognostic factors and hospitalization periods were analyzed in 57 consecutive children who had acute lymphoblastic leukemia diagnosed between 1967-1977, and who were followed up for at least 2 yr. Possible correlations between white blood cell (WBC) count, organomegaly and mediastinal enlargement at diagnosis, as well as age and sex, with the length of first remission and survival, were investigated. Children presenting with a combination of all of the following 4 risk factors-WBC count .gtoreq. 50,000/mm3, enlarged mediastinum, spleen and liver .gtoreq. 3 cm below the costal margin.sbd.comprised a poor-prognosis group, in which boys predominated. Age in this small group of patients had no correlation with prognosis. No specific risk factor was predictive for survival in the 48 children who had less than 4 of the risk factors. In this better-prognosis group, children < 2 yr and > 10 yr had a higher relapse rate than those of intermediate ages, and girls had a significantly better prognosis than boys. Age and sex are apparently intercorrelated with the above risk factors, so that analysis of the effect of a single risk factor or even a combination of two factors can be misleading. In the light of these findings, an interpretation of the discrepancies in the literature is suggested. Of interest, too, is the poor prognosis and the high frequency of T-cell leukemia among Arab children. The importance of day-care facilities that enable shorter hospitalization periods and improve the quality of life is stressed.

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