Premium
Subclassification of Acute Lymphoblastic Leukaemia in Children: Analysis of the Reproducibility of Morphological Criteria and Prognostic Implications
Author(s) -
Viana Marcos B.,
Maurer Helen S.,
Ferenc Christine
Publication year - 1980
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1980.tb05907.x
Subject(s) - reproducibility , medicine , oncology , childhood leukaemia , pediatrics , statistics , mathematics
S ummary . Stained smears of aspirated bone marrow obtained at time of diagnosis from 223 children with acute leukaemia were reviewed independently by three observers in a double‐blind fashion in order to assess the reproducibility and clinical significance of the French—American—British Cooperative Group Classification. In 170 cases of acute lymphoblastic leukaemia (ALL), triple agreement of 69.4% was reached in the subclassification into L 1 , L 2 and L 3 types. The closest degree of agreement between two observers was 86.8%. In children with blasts classified as L 1 , 57 of 61 patients (93.4%) remained in haematological remission after 12 months, as compared with 14 of 20 (70%) in children whose blasts were typed as L 2 morphology, a difference which was statistically significant ( P < 0.05). There was no difference when these groups were compared after 24 or 36 months. Children older than 7 years had an increased incidence of L 2 type ( P < 0.05). We conclude that although there may be significant variation in individual interpretations of the criteria utilized for classification, blast morphology may nevertheless be a useful prognostic factor.