Early deaths in newly diagnosed cases of pediatric acute leukemia: a Southwest Oncology Group Study

A reanalysis of all ten clinical trials conducted by the Southwest Oncology Group from 1958 thorugh 1976 in newly diagnosed pediatric acute leukemia was carried out to quantify the "early death" rate (i.e., rate of deaths during the first four weeks of remission induction) and to determine factors related to these deaths. Out of 1,964 patients registered, there were 126 (6.4%) early deaths. For the 1,375 acute lymphocytic leukemia (ALL) patients only, there were 75 (5.5%) early deaths. During the last eleven years on this study (1965 through 1976), the death rate for ALL patients appears to have remained stable at five deaths per 100 patients, despite the general improvement in overall survival. The most important prognostic factor was the initial platelet count: patients with a platelet count below 25,000 had a death rate over three times higher than that of patients with a platelet count over 75,000. Infants under one year of age also had a very high early death rate (6 of 41, 15%).