Long survival in childhood lymphoblastic leukaemia

Abstract

Summary Long term follow-up of 378 children with acute lymphoblastic leukaemia (ALL) treated at a single centre showed that at six years from diagnosis 202 (53%) were alive, of whom 140 (37%) remained in first remission. Only three children had a first relapse after six years. Children who survived six years despite a single extramedullary relapse in the testis or CNS were likely to remain in second remission but patients with previous marrow or with multiple relapses continued at risk for up to ten years from diagnosis. Presenting factors influencing event-free survival were: leucocyte count, age and sex. After allowing for these factors morphological (FAB) subtype and liver enlargement retained their prognostic significance. Immunological type of ALL was not of independent prognostic significance, except for the small number of patients with B-ALL. Most factors lost their significance after 2-4 years.It is concluded that patients alive 6 years from diagnosis without relapse or even with a single extramedullary relapse of ALL, have a high chance of prolonged survival and cure.

Medical cost of curing childhood acute lymphoblastic leukaemia

“…The outcome of the 62 relapsed patients has been reviewed elsewhere. 16 Group II comprises 44 patients-the 42 survivors of the 62 relapsed patients and the two surviving patients with late bone marrow relapses from group I. Tables I and II give details of these patients and their treatment.…”

“…A 16 year old has portal hypertension secondary to methotrexate induced hepatic fibrosis. A further two patients who have had intermittent episodes 165 of haematuria have lower bladder telangiectasia presumed to be due to a combination of cyclophosphamide and radiation scatter from their testicular radiotherapy field.…”

Acute lymphoblastic leukemia, the Indian scenario

“…The cure rates have improved from virtually zero, prior to the advent of modern chemotherapy and radiotherapy (in 1950s), to the current overall event-free survival rates of approximately 80%. [2][3][4] The cure rates of children with ALL in India are improving, akin to the western world. However, reports from several institutions in India suggest that outcome is inferior to that achieved in the west.…”

Late relapses after treatment for acute lymphoblastic leukemia in childhood: A population‐based study from the nordic countries

“…The concept of a cure for childhood leukemia has been debated, with various opinions expressed about the requirements for and the duration of disease-free survival [7,8]. We wish to contribute our experiences to that discussion.…”