Acute lymphoblastic leukaemia: the Wellington experience 1980-92

The study was designed to compare two populations of children with acute lymphoblastic leukaemia treated in the Wellington regional oncology unit over two six year periods, 1980-6 and 1986-92 when two different treatment protocols were used.

Fifty-eight cases were identified from the children's cancer registry and the relevant data collected from the hospital records. Overall survival and disease free survival in the two populations were compared.

There was a significant difference for both outcomes between the two study populations, those treated prior to August 1986 having an actuarial survival of 53% and a disease free survival of 47% compared with 93% and 88% in those children treated after August 1986 (p=0.01 and 0.001 respectively). This was not explained by differences in sex, age, area of residence at diagnosis or disease risk.

Increased intensity and duration of the induction and consolidation phase of treatment has significantly improved outcome for standard and high risk disease in children who have received the intensive phases of this treatment at a regional paediatric oncology centre. Outcome is not compromised if children receive the less intensive maintenance therapy close to their homes at the district or base hospital and close links are maintained with the regional unit.