TY - JOUR
T1 - Acute lymphoid leukemia in adolescents
T2 - Clinical and biologic features predict a poor prognosis - A Pediatric Oncology Group study
AU - Crist, W.
AU - Pullen, J.
AU - Boyett, J.
AU - Falletta, J.
AU - Van Eys, J.
AU - Borowitz, M.
AU - Jackson, J.
AU - Dowell, B.
AU - Russell, C.
AU - Quddus, F.
AU - Ragab, A.
AU - Vietti, T.
PY - 1988
Y1 - 1988
N2 - Analysis of remission induction rates for 1,768 children (1.5 to 11 years) and 425 adolescents (≥ 11 years) with acute lymphoid leukemia (ALL), and of event-free survival times for 570 children and 147 adolescents, disclosed that adolescents fared significantly worse by both measures of treatment outcome (P = .0001). Adolescents with either T cell or non-T cell ALL entered remission significantly less often than did children (P = <.02 and P = <.001, respectively). Within each of the major immunophenotypes of ALL, adolescents had shorter durations of continuous complete remission: early pre-B (non-B, non pre-B, non-T) (P = .001), pre-B (P = .05), and T (P = .027). We compared the clinical characteristics of adolescents and children, and lymphoblast characteristics present at diagnosis to account for the inferior prognosis of adolescent patients. Adolescents had a higher incidence of T cell ALL (P = .0001) and thus a higher incidence of all T cell-associated characteristics. Adolescents with non-T, non-B ALL were more likely to be male (P = .044), and to have higher leukocyte counts (P = .002) and lower levels of IgG (P = .0003), IgA (P = .0001), and IgM (P = .002). Their leukemic cells had lower PAS scores (P = .0001), a higher incidence rate of L2 morphology by French-American-British (FAB) criteria (P = .001), common ALL antigen negativity (P = .0001), and hypodiploid or pseudodiploid karyotypes (P = .004). These findings clearly indicate an increased incidence of prognostically unfavorable clinical and biologic features in adolescents with ALL, providing a biologic explanation for their poor prognosis.
AB - Analysis of remission induction rates for 1,768 children (1.5 to 11 years) and 425 adolescents (≥ 11 years) with acute lymphoid leukemia (ALL), and of event-free survival times for 570 children and 147 adolescents, disclosed that adolescents fared significantly worse by both measures of treatment outcome (P = .0001). Adolescents with either T cell or non-T cell ALL entered remission significantly less often than did children (P = <.02 and P = <.001, respectively). Within each of the major immunophenotypes of ALL, adolescents had shorter durations of continuous complete remission: early pre-B (non-B, non pre-B, non-T) (P = .001), pre-B (P = .05), and T (P = .027). We compared the clinical characteristics of adolescents and children, and lymphoblast characteristics present at diagnosis to account for the inferior prognosis of adolescent patients. Adolescents had a higher incidence of T cell ALL (P = .0001) and thus a higher incidence of all T cell-associated characteristics. Adolescents with non-T, non-B ALL were more likely to be male (P = .044), and to have higher leukocyte counts (P = .002) and lower levels of IgG (P = .0003), IgA (P = .0001), and IgM (P = .002). Their leukemic cells had lower PAS scores (P = .0001), a higher incidence rate of L2 morphology by French-American-British (FAB) criteria (P = .001), common ALL antigen negativity (P = .0001), and hypodiploid or pseudodiploid karyotypes (P = .004). These findings clearly indicate an increased incidence of prognostically unfavorable clinical and biologic features in adolescents with ALL, providing a biologic explanation for their poor prognosis.
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U2 - 10.1200/JCO.1988.6.1.34
DO - 10.1200/JCO.1988.6.1.34
M3 - Article
C2 - 3422091
AN - SCOPUS:0023835131
SN - 0732-183X
VL - 6
SP - 34
EP - 43
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 1
ER -