[Evaluation of initial risk factors in acute lymphoblastic leukemias in children]

In an attempt to establish a possible correlation between clinical course and initial characteristics of the disease, 88 children with ALL (diagnosed between 1970-1978) were studied. Basis for comparison was whether relapses (medullary or extramedullary) occurred within 36 months. Twenty parameters, including history data, physical exploration, laboratory findings and early response to induction treatment, were evaluated. Statistical analysis showed a significant influence of the following factors: age less than 1 year, organomegalies (hepato or splenomegaly larger than 5 cm B.C.M.), adenomegalies (more than 3 cm in diameter), mediastinal mass, initial CNS infiltration, E-rosette forming blast-cells, acid phosphatase positivity and a good hematological response after 2nd week of treatment. Sex appeared as a prognostic factor after 36 months. Three group of patients could be distinguished according to risk factors: A) Patients without risk factors; 70.45% in continuous remission (CR) after 36 months. B) Patients with 1-2: 43.47% in CR at 36 months. C) Three or more: None attained 36 months in continuous CR. Differences are significant (p less than 0.05).