Evaluation of patient age as a risk assigment parameter in high risk acute lymphocytic leukemia

Historically, age has been used as criteria for risk group assignment in patients with acute lymphocytic leukemia (ALL). The prognosis varies among different age groups. Differences in the biological characteristics of the leukemic clone and clinical findings at diagnosis are also used for risk assignment in ALL. It is our hypothesis that age is a lesser risk defining parameter than are the biological characteristics of the leukemic clone and the clinical characteristics at presentation. An analytic, retrospective study was conducted where fifty-seven patients were evaluated. Patients were divided in two subgroups: nine years and older (up to 18 years of age) patients with favorable biological characteristics of the leukemic clone and favorable clinical findings at diagnosis (riesgo 0) and nine years and older (up to 18 years of age) patients with unfavorable characteristics of the leukemic clone and/or unfavorable clinical findings at diagnosis (riesgo 1). All patients received treatment according to the same treatment protocols. The subgroup of patients with favorable ALL characteristics (riesgo-0) showed an increased median survival time of 11 years compared to those patients with unfavorable ALL characteristics (riesgo-1) who had a median survival time of 5.4 years. Age as a risk assignment perameter had a minimal impact in survival in patients whose leukemia had good biologic characteristics treated on these treatment protocols.