title: Prognostic factors and outcome for children after second central nervous system relapse of acute lymphoblastic leukaemia.
abstract: The Medical Research Council acute lymphoblastic leukaemia trials (UKALL X and XI) recruited 3,702 children with ALL between January 1985 and March 1997. Seventy-nine children had central nervous system (CNS) involvement in their first two relapses. Fourteen children survived at a median follow-up of 22 months from second relapse; seven (9%) in third remission, two in later remissions and five with disease. Factors predictive of survival from second relapse were site (isolated CNS was better than combined CNS, P = 0.02) and time from diagnosis to second CNS relapse (longer time was better, P = 0.004). Prognosis after second CNS relapse is extremely poor, and palliative therapy is appropriate.
authors.affiliation: Department of Haematology, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Emma C
authors.initials: EC
authors.lastname: Morris
authors.forename: Georgina
authors.initials: G
authors.lastname: Harrison
authors.forename: Clifford C
authors.initials: CC
authors.lastname: Bailey
authors.forename: Ian M
authors.initials: IM
authors.lastname: Hann
authors.forename: Frank G
authors.initials: FG
authors.lastname: Hill
authors.forename: Brenda E S
authors.initials: BE
authors.lastname: Gibson
authors.forename: Susan
authors.initials: S
authors.lastname: Richards
authors.forename: David K H
authors.initials: DK
authors.lastname: Webb
mesh_terms: D016543:Central Nervous System Neoplasms / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis