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Can late relapse be predicted at initial diagnosis in childhood acute lymphoblastic leukemia?
Author(s) -
Rautonen Jukka,
Siimes Martti A.
Publication year - 1989
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1989.tb00285.x
Subject(s) - medicine , discontinuation , multivariate analysis , confidence interval , lymphoblastic leukemia , gastroenterology , population , acute lymphocytic leukemia , pediatrics , oncology , leukemia , environmental health
We have investigated whether any prognostic factor can be used to identify those children who have a relapse after discontinuation of therapy for acute lymphoblastic leukemia (ALL). Our population‐based series comprised 167 children with newly diagnosed ALL. The 3‐year event‐free survival rate in these children was 65%. Maintenance therapy was electively discontinued for 120 patients, 20 of whom have subsequently had a relapse 1 to 27 months later. In multivariate analysis the risk of late relapse in the 15 patients with initially enlarged kidneys was 4.5‐fold (95% confidence limits 1.7–11.8) that of the others (p < 0.01). The risk in the 18 patients with initially elevated CSF protein concentration (> 0.4 g/l) or leukocyte count (> 5 × 10 6 /l), but with no blasts in the CSF, was 3.8‐fold (1.5–9.6) that of the others (p < 0.01). Our results indicate that enlarged kidneys or abnormal CSF findings at initial diagnosis are associated with an increased risk of late relapse in children with ALL.