Results of treatment of high risk childhood acute lymphoblastic leukemia

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Abstract
Sixteen children with high risk acute lymphoblastic leukemia (ALL) who had one or more of the following risk factors: white cell count over 50 × 109/liter, mediastinal mass, age under 2 or over 10 years, extramedullary involvement, or T‐cell markers, were treated by a new protocol. All attained complete remission and 11 are still in their continuous first remission for 6‐53 months. High activity of adenosine deaminase (ADA) in the leukemic cells seems to be an independent risk factor, as in the high ADA level group, 4 out of 7 patients relapsed and died, while none of the 8 patients with low ADA levels relapsed or died.