Anemia and survival in childhood acute lymphoblastic leukemia.
نویسندگان
چکیده
BACKGROUND Several studies have demonstrated that patients with childhood acute lymphoblastic leukemia presenting with mild anemia at diagnosis have an increased risk of poor outcome compared to patients with more severe anemia. However, it has not been reported whether there is any correlation between degree of anemia and leukemia subtype. DESIGN AND METHODS In a cohort of 1162 patients with childhood acute lymphoblastic leukemia we analyzed whether there was a correlation between degree of anemia and leukemia subtype. We also studied the association between degree of anemia and event-free survival within the subtypes. RESULTS Hemoglobin levels at diagnosis were distributed in a non-random pattern. The degree of anemia was significantly different for three distinct groups of patients compared to the remaining patients (mean hemoglobin; T-cell leukemia: 106 g/L versus 76 g/L (precursor B-cell acute lymphoblastic leukemia); within precursor B-cell ALL: TEL-AML1 positive: 68 g/L versus 79 g/L; BCR-ABL positive: 93 g/L versus 76 g/L; each p<0.05). Furthermore, in contrast to the entire study group, patients with T-cell leukemia, TEL-AML1(+), and BCR-ABL(+) precursor B-cell leukemia had a more favorable prognosis if presenting with a higher hemoglobin level (>/=80 g/L). CONCLUSIONS These observations indicate that the formerly reported direct correlation between severity of anemia and survival in childhood acute lymphoblastic leukemia mainly reflects differences in the degree of anemia between distinct biological subgroups with different treatment outcomes. On the other hand, the inverse relationship between severity of anemia and survival found within specific subgroups suggests that very low hemoglobin levels at diagnosis are associated with more advanced disease in these subgroups.
منابع مشابه
گزارش یک مورد لوسمی مادرزادی و مروری بر مقالات
Although leukemia is the most common malignancy in childhood, congenital leukemia which manifests itself within the first 4 weeks of life is rare and accounts for less than 1% of all leukemias in childhood. Congenital leukemia should be differentiated from transient myeloproliferative disorder(TMD) which is noted in Down Syndrome. Among the reported patients, acute myeloid leukemia(AML) was...
متن کاملPresenting Clinical and Laboratory Data of Childhood Acute Lymphoblastic Leukemia
Abstract Background Leukemia is the most prevalent childhood cancer and Acute Lymphoblastic Leukemia (ALL) constitutes 75% of all cases. The most frequent presenting symptoms are fever, weight loss and pallor. Early detection of clinical symptoms positively affects timely diagnosis. The objectives of the present study were to assess frequency of presenting symptoms, laboratory data, immune ph...
متن کاملEvaluation of Relationship between Minimal Residual Disease (MRD) and Relapse in Childhood Acute Lymphoblastic Leukemia (ALL) Using Quantitative Fluorescent PCR
متن کامل
Face Bones Involvement and Relapse in a Case of Childhood Acute Leukemia
Midface bones are an unusual site for primary presentation and relapse in acute lymphoblastic leukemia. Herein, we describe a case of acute pre B cell lymphoblastic leukemia with leukemic infiltration of maxilla and bone marrow involvement. At the time of relapse, the patient presented again with maxilla involvement and the phenotype changed to biphenotypic lymphoblastic leukemia. Our case sug...
متن کاملEvaluation of bone mineral density in long-term survivors of childhood acute lymphoblastic leukemia
Background: The purpose of this study was to evaluate long-term changes in bone density profile among survivors of childhood acute lymphoblastic leukemia. Patients and Methods: This was a 5 year prospective study comprised of thirty-one survivors of childhood acute lymphoblastic leukemia with a mean age of 11.8 (4.6) years, who completed therapy at least 1 year previously (according to the ...
متن کاملBone Density in Pediatric Patients with Acute Lymphoblastic Leukemia (ALL): A Literature Review
Introduction: Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in children and the main form of childhood leukemia (75%). ALL different treatment options have a great impact on children weight and appetite. The improving prognosis for children with cancer refocuses attention to long-term outcomes with an emphasis on quality of life. More survival rate allows researchers to eval...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Haematologica
دوره 93 11 شماره
صفحات -
تاریخ انتشار 2008