[MICM classification and prognostic analysis of 80 adolescents with acute lymphoblastic leukemia].
OBJECTIVE
To explore MICM classification and adverse prognostic factors in adolescents with acute lymphoblastic leukemia (ALL).


METHODS
The MICM classification, clinical characteristics of 80 adolescents with ALL admitted to our hospital from January 1998 to December 2002 were retrospectively analyzed. Survival data were estimated by the Kaplan-Meier method and the prognostic factors were analyzed with the COX regression model.


RESULTS
In the 80 patients, B-ALL and T-ALL accounted for 69.12% and 26.47%, respectively. The percentage of Ph(+)ALL was 18.37% (9/49), and that of hyperdiploidy was 4.08%. Patients at diagnosis with high leukocyte counts (> 50 x 10(9)/L) accounted for 27.94%. Among the 78 cases treated with VDP(L) or CODP(L) regimens, 73 (91.03%) obtained CR in 4 weeks. After a median follow-up of 24 months, the estimated 3-year disease-free survival (DFS) rates of patients receiving chemotherapy or allo-HSCT were (32.55 +/- 16.50)% and (69.58 +/- 8.72)%, respectively (P < 0.05). In COX analysis, high initial leukocyte counts (> 50 x 10(9)/L) and Philadelphia chromosome positivity were adverse prognostic factors for long-term survival.


CONCLUSIONS
MICM classification has important clinical and prognostic significance in the risk-directed therapy of adolescents with ALL. The adverse prognostic features for these patients were high leukocyte counts, less incidence of chromosome hyperdiploidy and Ph chromosome positivity.
Kong
Yuan
Y
Institute of Hematology and People's Hospital of Peking University, Beijing 100044, China.
Jiang
Bin
B
Wang
De-bing
DB
Liu
Kai-yan
KY
Huang
Xiao-jun
XJ
Lu
Xi-jing
XJ
Sun
Zhi-qiang
ZQ
Lu
Dao-pei
DP
D000293:Adolescent; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007621:Karyotyping; D007958:Leukocyte Count; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification* / Q000235:genetics / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors