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A retrospective study on 190 children with acute lymphoblastic leukaemia and marrow relapse on therapy demonstrated a universally poor prognosis with a high risk of extramedullary leukaemia. 49.1% of children achieved a second remission, the median duration of haematological remission being 97 days. The median duration of survival was 157 days, with no survivors beyond 2 years 3 months from relapse. Children with high white blood counts at diagnosis, those relapsing early and older children had a particularly poor prognosis. Children who achieved a first remission with difficulty and those receiving regular vincristine and prednisolone in their remission were less likely to achieve a second remission. Those who failed to go back into remission with the more commonly used drugs were not usually responsive to other drugs.

Marrow relapse on maintenance chemotherapy in childhood acute lymphoblastic leukaemia