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Staging of acute leukemia and the relationship to CNS involvement. Staging of all and CNS disease
Author(s) -
Fitzpatrick John,
Lieberman Nancy,
Sinks Lucius F.
Publication year - 1974
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197405)33:5<1376::aid-cncr2820330524>3.0.co;2-v
Subject(s) - medicine , spleen , leukemia , pathology , lymph , nodal , disease , gastroenterology
One hundred eighty‐two children with acute lymphoblastic leukemia (ALL), reticulum cell sarcoma (RCS), and lymphocytic lymphosarcoma (LS) were divided into four groups as follows: Group 1—LS or RCS which never undergoes leukemic conversion; Group 2—Gross nodal enlargement either ALL from diagnosis or localized LCS or RCS subsequently converting to ALL; Group 3—ALL with palpable spleen or liver, but no gross nodal enlargement; Group 4—ALL without palpable spleen, liver, or gross nodal enlargement. It was found that Group 4, despite a superior survival (42.5 months), had a reduced incidence (31.8%) of central nervous system leukemia. Leukemic “conversion” of LS or RCS and ALL with gross nodal enlargement (Group 2) had the shortest survival (median 8.5 months) but a relatively high percentage (58.8%) with CNS disease. In non‐converting LS or RCS (Group 1) only 20% had CNS involvement. On histologic criteria alone, 14.3% with RCS had CNS disease, whereas 57.9% of those with LS were affected. It is felt that a distinct adverse relationship exists between extra medullary enlargement of spleen, liver, and lymph nodes at diagnosis and the subsequent involvement of the CNS in ALL and transforming LS.