MODIFIED LSA2-L2 TREATMENT IN 53 CHILDREN WITH E-ROSETTE-POSITIVE T-CELL LEUKEMIA - RESULTS AND PROGNOSTIC FACTORS (A PEDIATRIC ONCOLOGY GROUP-STUDY)

  • 1 January 1982
    • journal article
    • research article
    • Vol. 60  (5) , 1159-1168
Abstract
To improve the poor outlook for children with T-cell keukemia (T-ALL), the Southwest Oncology Group [USA], Pediatric Division, used a modified LSA2-L2 multidrug regimen to treat 53 patients with erythrocyte-rossette-positive T-ALL. This regimen was chosen because of its demonstrated efficacy in T-cell (mediastinal) non-Hodgkin''s lymphoma. Complete remission (CR) rate was 88%. Range of follow-up for those patients remaining in CR is 24-49 mo. (median 39 mo). Life table analysis estimates that 40% (SE 8.3%) of all patients who started induction therapy will remain failure-free at 3 yr. For patients achieving CR, 46% (SE 9%) are projected to remain in both marrow and extramedullary CR at 3 yr. Median failure-free duration was 13 mo. but only 1 patient has relapsed beyond 16 mo. Of initial relapses, 29% were isolated CNS relapses. The following presenting factors did not relate significantly to outcome: Hb, platelet count, uric acid, race and mediastinal mass. Age > 10 yr was a poor prognosis indicator only in the < 50,000/.mu.l WBC [white blood cell] group. Sex was not a significant factor after adjusting for WBC. WBC was the most important prognostic factor: 19% (SE 8%) of patients with WBC > 50,000/.mu.l are projected to remain failure-free at 3 yr as compared to 67% (SE 11%) of patients with WBC < 50,000/.mu.l. Although the overall results are better than those previously reported for pediatric patients with T-ALL, the long-term failure-free rate remains low for patients presenting with > 50,000/.mu.l WBC.