Clinical Observation on Factors Influencing Survival in Pediatric Acute Lymphocytic Leukemia

Hong, Chang Yee; Choi, Jung Yeun; Ahn, Hyo Seop

Abstract

Sixty two properly treated acute lymphocytic leukemia cases who were diagnosed at SNUH, from 1958 to July, 1981 were studied. Among them, 20 cases had survived more than 3 years and 42 cases survived less than 3 years. The 11 cases of 20 are now alive and off theray and the remainder 9 cases were expired after survival for more than three years. The clinical features of the 11 currently living cases are as follows. The survival time of 11 cases are 3 years and 1 month - 16 years and 1 month. Except one case, first remission have continued till now. Average leukocyte count and liver size are 7,710/mm3 and 1.5 fingerbreadth respectively. The proportion of cases who showed splenomegaly, lymph node enlargement and hemorrhagic phenomena is 18.2%, 9.1% and 36.4% respectively. The clinical features of the 9 expired cases are as follows. Average leukocyte count is 7,780/mm3 and average liver size is 2.4 finger-breadth and average spleen size is 2.8 fingerbreadth. The proportion of cases who showed lymph node enlargement and hemorrhagic phenomean in 50.0% and 37.5% respectively. The clinical features of 29 cases who attained initial remission but survived less than 3 years are as follows. Average leukocyte count, liver size and spleen size 72,910/mm3, 2.8 finger-breadth and 2.0 finger-breadth respectively. The proportion of cases who showed lymph node enlargement and hemorrhagic phenomean is 52% and 75.9% respectively. The clinical features of 13 cases who died before initial remission are as follows. Average leukocyte count, liver size and spleen size are 244,570/mm3, 2.4 finger-breadth and 2.0 finger-breadth respectively. The proportion of cases who showed lymph node enlargement and hemorrhagic phenomena is 53.8% and 90.9% respectively. Various prognostic factors were related to duration of survival. The proportion of cases who were over 10 years of age at diagnosis and male to female ratio are higher in cases who survived less than 3 years. The leukocyte count, liver size, proportion of lymph node enlargement and proportion of hemorrhagic phenomeana are significantly lower in long survivors. In long survivors, spleen size in smaller but statistically not significant.