Boys but not girls with T-lineage acute lymphocytic leukemia (ALL) are different from children with B-progenitor ALL. Population-based data results of initial prognostic factors and long-term event-free survival. Swiss Pediatric Oncology Group.
OBJECTIVE
In a population-based data registry of children with ALL, initial prognostic factors were analyzed with regard to long-term event-free survival.


METHODS
From 1976-1991 the Swiss Pediatric Oncology Group (SPOG) observed 610 children and adolescents who were diagnosed with ALL before the age of 15 years, and who were prospectively treated according to different study protocols. Immunophenotyping of B-progenitor- or T-lineage ALL was possible in 573 children. Leucocyte count, age, and sex were compared with regard to immunophenotype of lymphoid cells and to event-free survival on Kaplan Meier curves by statistical analyses including multivariate analysis and the Cox regression backward elimination test.


RESULTS
Of the 573 patients who were immunophenotyped 86.4% had B-progenitor ALL and 13.6% T-lineage ALL. The differences between B-progenitor ALL and T-lineage ALL with respect to initial white blood cell count, age and gender were significant. A comparison of event-free survival in children with B-progenitor ALL versus T-lineage ALL revealed significant differences in boys (p < 0.001) but not in girls (p = 0.183). Statistical tests showed gender to be an independent risk factor.


CONCLUSIONS
The long-term outcome following identical treatment of both genders was significantly better in girls with T-lineage ALL than in boys. Girls with T-lineage ALL, but not boys with T-lineage ALL, had a prognostic outcome similar to children with B-progenitor ALL.
Imbach
P
P
Children's Hospital Aarau and Basle, University of Basel, Switzerland.
Fuchs
A
A
Berchtold
W
W
Arnet
B
B
Stupnicki
A
A
Angst
R
R
Signer
E
E
D001402:B-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012737:Sex Factors; D013234:Stem Cells / Q000276:immunology*; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors