Day 7 marrow response and outcome for children with acute lymphoblastic leukemia and unfavorable presenting features
- 1 January 1990
- journal article
- research article
- Published by Wiley in Medical and Pediatric Oncology
- Vol. 18 (4) , 273-279
- https://doi.org/10.1002/mpo.2950180403
Abstract
The percent of marrow blasts on day 7 of therapy was determined for 128 children with previously untreated acute lymphoblastic leukemia and white blood count (WBC) ± 50,000/μl and/or lymphomatous features enrolled in the Childrens Cancer Study Group trial of the Berlin Frankfurt Munster 76/79 regimen (CCG‐193P). Patients received four‐drug induction therapy including vincristine, prednisone, l‐asparaginase, and daunomycin. Ninety‐seven patients had fewer than 25% marrow blasts on day 7. Of these, 94 survived and maintained remission through day 28 and were designated early responders. Thirty‐one patients had greater than 25% marrow blasts on day 7. Of these, 28 survived and achieved remission on day 28 and were designated late responders. The outcome of patients who underwent a day 7 marrow aspiration was similar to those who did not. Early responders had a 77.4% ± 4.5% (standard deviation) 3‐year estimated disease free survival, while late responders had 47.3% ± 9.8% (PP = 0.025) and in the subset with a WBC ± 50,000/μl (P = 0.01). The day 7 marrow response had prognostic value in this population of children with unfavorable presenting features who received four‐drug remission induction therapy.Keywords
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