Children with Philadelphia chromosome positive Acute Lymphoblastic Leukemia (ALL) tend to have a poor prognosis. Certain clinical features identify patients with a better prognosis, while certain therapies are associated with better survival. The study was done at several institutions in both Europe and North America.
Study population: 326 patients from ages 0.4 to 19.9 years with ALL showing chromosomal translocation t(9;22)
Prognostic Group
Modified Rome-National Cancer Institute Criteria
good
(WBC count < 50,000 per µL) AND (age < 10 years)
intermediate
(WBC count >= 50,000 AND <= 100,000 per µL)
(WBC count < 50,000 per µL) AND (age >= 10 years)
poor
> 100,000 per µL
after Figure 1, page 1003
Prognostic Group
5 Years Disease Free Survival
good
49% (+/- 5)
intermediate
30% (+/- 5)
poor
20% (+/- 5)
Treatment options:
(1) transplantation of bone marrow from an HLA-matched related donor offers the best outcome
(2) intensive chemotherapy may control the disease in some patients with favorable prognostic features.
(3) transplantation of marrow from a mismatched related donor or of autologous marrow was not superior to chemotherapy alone
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