Sex and other prognostic factors in acute lymphoblastic leukemia in childhood

A complete national material of children with acute lymphoblastic leukemia diagnosed in the years 1973-1980 was analyzed with regard to prognostic differences between males and females. In accordance with international criteria (age, WBC, CNS involvement, and mediastinal mass), the children were classified as standard risk (SR) and increased risk (IR). Thirty-eight percent of the males and 32% of the females fulfilled criteria for assignment to the group with an increased risk. A linear multiple regression analysis on the material showed that WBC was the most important prognostic criterion, followed by sex, age, and mediastinal mass. The prognosis was significantly poorer for males in the standard risk (p less than 0.03) and in the increased risk group (p less than 0.0001). The IR criteria were more valid for males than for females. Serious complications resulting from therapy were more frequently reported for females than for males. These studies suggest that sex is of significance both for the prognosis and for the efficacy of treatment.