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 Release 22.0, Sept. 2008
 
The Medical Algorithms Project
Chapter : ch28. Oncology: Hematologic Section : Acute Lymphoblastic Leukemia (ALL)
  Prognostic Factors in Children with Philadelphia Chromosome Positive ALL

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Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

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

• ages 0.4 to 19.9 years

• ALL with 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

 

  References:

Arico M, Valsecchi MG, et al. Outcome of treatment in children with Philadelphia chromosome-positive Acute Lymphoblastic Leukemia. N Engl J Med. 2000; 342: 998-1006.

 

 
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