Health status of patients with childhood acute lymphoblastic leukemia in continuous complete remission for over five years. The Taiwan Children's Cancer Study Group.
Ninety-seven patients with childhood acute lymphoblastic leukemia (ALL) have achieved complete continuous first remission for more than five years. They were treated by Taiwan Children's Cancer Study Group protocol 821 or protocol 842. Their present health status was evaluated using blood counts, immunology, a psychiatric analysis and growth parameters. Hemoglobin and platelet counts rose quickly to the normal range after complete remission was achieved, then remained at low normal throughout the course. The leukocyte counts responded immediately to chemotherapy, usually recovering to about 5,000/uL, then gradually increasing after completion of chemotherapy. The absolute neutrophil counts were at a low normal level during chemotherapy, then gradually recovered to the normal level after chemotherapy was completed. Immunologic investigation after completion of chemotherapy showed that the subsets of lymphocytes were nearly all in the normal range for the 38 patients tested. On the other hand, in 17 patients tested for T-cell function, it was found that 29.4% had low natural killer (NK) cell cytotoxicity, 11.8% had an abnormal phytohemagglutinin (PHA) test and all had abnormally low IL-2 production (in vitro). There were 29 patients who had psychiatric analyses; the full IQ was borderline in 10.3%. The primary or middle school academic scores of 55 patients were reported; 15% of them belonged to the lower one-third of the class. Height was assessed by the standard deviation score from the mean for 58 patients. The differences were statistically insignificant; however, there were six patients whose growth curves crossed over their initial percentile line.(ABSTRACT TRUNCATED AT 250 WORDS)
Lin
S T
ST
Department of Pediatrics, Taipei Medical College Hospital, Taiwan, R.O.C.
Yang
C P
CP
Liang
D C
DC
D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000534:rehabilitation* / Q000628:therapy; D012074:Remission Induction; D013624:Taiwan