Improvement in outcome for children with acute nonlymphocytic leukemia. A report from the childrens cancer study group

Abstract

The Childrens Cancer Study Group conducted four therapeutic studies on a total of 1006 children with acute nonlymphocytic leukemia from 1972 to 1983. This report describes the therapeutic strategies of these studies and examines trends in induction rates and long‐term outcome over this period. The remission induction rate has changed from 58% in 1972 to 1975 to 80% for the period 1980 to 1983, and the induction mortality dropped from 20% to 6%. Four‐year survival probabilities from time of diagnosis have almost doubled from 19% to 36%. Few deaths occurred more than 5 years after diagnosis: children surviving in first remission beyond 5 years had a 92% survival rate and an 86% relapse‐free survival rate over the next 5 years. In contrast, median survival after a marrow relapse was less than 6 months and the 6‐year survival probability was 4%. The leukocyte count was a significant prognostic factor, and although the mortality for infants was high initially, long‐term survival was not decreased. Copyright © 1989 American Cancer Society