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Long‐term survival in childhood acute lymphocytic leukemia in Italy
Author(s) -
Mandelli Franco,
Amadori Sergio,
Ceci Adriana,
Guazzelli Carlo,
Madon Enrico,
Marchi Antonietta,
Masera Giuseppe,
Paolucci Guido,
Zanesco Luigi
Publication year - 1981
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(19811201)48:11<2364::aid-cncr2820481104>3.0.co;2-y
Subject(s) - medicine , acute lymphocytic leukemia , pediatrics , leukemia , mediastinal mass , acute leukemia , surgery , lymphoblastic leukemia
Among 727 children with acute lymphocytic leukemia (ALL) observed at eight pediatric clinics in Italy in the years 1967–1974, 200 (27.5%) survived for more than five years after diagnosis. The proportion of long‐term survivors rose significantly during the years 1970–1974 when aggressive therapeutic programs with curative intent were uniformly adopted in Italy (19.8% vs. 29.4%; P < 0.05). Clinical and laboratory data at diagnosis of the 200 long‐term survivors were analyzed and compared with that of the 527 nonsurvivors. We found that, besides a leukocyte count greater than 50,000 cells/mm 3 , other factors such as early central nervous system CNS leukemia and the presence of mediastinal mass were predictive of a poorer prognosis for long‐term survival. Life‐table analysis revealed that the chance of long‐term survival was significantly higher in those children who have survived for five years without relapse (82.9% vs. 24.1%; P < 0.01). Although late initial relapse is always possible, if a child with ALL remains in continuous complete remission for at least nine years, it is likely that the patient is cured.