Studies on Initial Features and Prognosis in 21 Infants with Acute Lymphoblastic Leukemia

Abstract

Between 1972 and 1985, 21 children less than 1 year of age were treated with treatment programs of the Children's Cancer & Leukemia Study Group for acute lymphoblastic leukemia (ALL).
The presenting features and natural history were assesed in these infants with ALL (group I). The results were compared with that of the other two groups (Group II: 483 children between the ages of 1 and 9, Group III: 83 children over than 10 years).
The infants with ALL presented with a higher prevalence of leukocyte counts over 100×10³/mm³, hepatosplenomegaly, thrombocytopenie and shorter duration of remission than those in the other two groups.
The continuous complete remission rate of these infants with ALL was 43.0% at 1 year.
Some infections complication during induction and maintenance phase were experienced. Two patients had several septic episodes. Two patients had syndrome of inappropriate scecretion of antidiuretic hormone the other patients had chicken pox.
The prognosis of ALL is especially poor when the diagnosis were before 1 year of age. It can only be improved by a very intensive chemotherapeutic approach, which, particularly at this age, implies equally intensive and specific supportive cares. Also, alternative approaches to central nervous system prophylaxis are needed to reduce the high prevence of CNS disease and toxicity.