Lack of prognostic value of lymphoblast size in acute lymphoblastic leukaemia

There are conflicting reports about the relationship of cell size and type to prognosis in acute lymphoblastic leukaemia (ALL). For this reason, bone marrows at diagnosis and first relapse were studied in 56 children with ALL treated on the same protocol. Lymphoblasts greater than 12 mmu in diameter were called macrolymphoblasts (MLB). Forty-one of 56 initial bone marrows had less than 20% MLB(group A), and 15 had greater than 20% MLB (group B). Median survival, complete remission rate, first remission duration, and the distribution of CNS leukaemia were similar in both groups. First relapse marrows were examined from 50 patients and a significant increase in MLB compared to initial pre-treatment bone marrows (18% vs 8%) was found.