An analysis of 55 adult patients (age >15 yr) with previously untreated acute lymphoblastic leukemia (ALL) was undertaken to correlate presenting clinical features with outcome of treatment. Patients achieving complete remission (CR) were compared to those without CR for the presence or magnitude of 24 pretreatment characteristics. The effect of each characteristic on remission duration and survival was studied using the proportional hazards method. Younger age predicted longer remission duration and survival but was not related to attainment of CR. The L1 FAB subtype was more frequently associated with CR than was L2. It predicted longer remission duration and survival compared to L2, but when age was considered concurrently, the effect of FAB subtype was lost for remission duration and considerably diminished for survival. The absence of infection favored attainment of CR, and elevated serum creatinine had a negative effect on survival. Statistically less certain associations were marrow cellularity >90% and absence of weight loss favoring CR; female sex and lower neutrophils and hemoglobin favoring longer remission duration; and lower aspartate transaminase favoring longer survival. Total numbers of white cells, blasts or platelets, fever, purpura, organomegaly, lymphadenopathy, and other serum chemistries were not significantly related to outcome. For adults with ALL, these results both confirm and repudiate previously noted prognostic associations and demonstrate that many important prognostic indicators of childhood ALL do not apply to the adult disease.
ASJC Scopus subject areas
- Cell Biology