The cases of one hundred and forty-one patients (85 males, 56 females) treated for hyperleucocytic acute lymphocytic leukemia (H-ALL) were reviewed. In all cases the initial white blood cell count was over 100,000/cu mm. One hundred patients (71%) attained complete remission (CR). The median duration of CR was six months and the median survival was nine months for all patients and 11 months for those who attained CR. Age, initial hemoglobin, and the height of initial white blood cell count over 100,000 had no significant prognostic value. Relapses occurred earlier in patients with a mediastinal mass. The results depended on the treatment used. With modern treatment, including more intensive chemotherapy and central nervous system prophylaxis, CR rate increased from 65% to 81% and median duration of CR improved from four months to ten months. The most important prognostic difference was related to the sex: CR rate was higher (78.5% vs. 66%) and median duration of CR and hematological remission was longer for females (nine months vs. six months and ten months vs. 6.5 months, respectively). This difference only appeared with modern treatments, however: before 1972 the median duration of CR was four months for both sexes, and after 1972, it was eight months for males and 17 months for females. This difference could be explained by the site of the first relapse, which was testicular in only 2% of cases before 1972 and 27% (47% of the males who relapsed) after 1972.

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A retrospective analysis was performed on 32 patients suffering from Hodgkin’s disease with bone marrow involvement treated between 1972 and 1976. After 6 courses of chemotherapy (MOPP for 25 patients), we observed 20 complete remissions (62.5%), 8 lymph node partial remissions (bone marrow sterilization but persistence of pathological lymph nodes) and 4 failures. Among the 28 complete or partial responders, 17 received maintenance chemotherapy alone, 9 were submitted to 40 Gy and 2 to 20 Gy irradiations. 15 patients died and 8 relapses occurred – all in previously involved lymph node areas. Survival of complete and partial responders is significantly different (p = 0.01) according to whether they received maintenance chemotherapy alone (34.5%) or irradiation (75.7%). Disease-free duration is also significantly different (p = 0.05) according to whether the patients received maintenance chemotherapy alone (42.1%) or 40 Gy irradiation (100%).

The complete hematological remission (CHR) rate, duration of remission and survival were studied in relation to age, peripheral blast cell (PBC) count, presence or absence of tumor masses, cytological type, and treatment in 650 patients with acute lymphoblastic leukemia. Prognostic factors were considered separately and divided into prognostic classes. Age and PCB count correlated with both the rate and the duration of CHR. This correlation was still observed for more recent treatment schedules though it appears to be becoming progressively less significant. Meningeal relapses were more common in patients less than 1 year old and in those with a high PCB count. It is suggested that stratification of patients according to such factors as age, PCB count, presence or absence of tumor, and cytological type might be necessary for the design of new treatment protocols and for the evaluation of their results.