Biologic features and treatment outcome of secondary acute lymphoblastic leukemia--a review of 101 cases.
BACKGROUND
Secondary acute lymphoblastic leukemia (sALL) is a rare disease and its biologic features are not well characterized.


METHODS
We describe a cohort of seven patients and discuss 94 additional cases from the literature for whom biological parameters were described. Cases with incomplete data were excluded.


RESULTS
Hodgkin's disease (HD) was more common in the 18-59 age group while breast and prostate cancers were prevalent only in the >or=18-year-old patients. The time interval to develop sALL was similar among all age groups but was significantly longer for HD and neuroblastoma primary diagnoses and sALL with complex karyotype. T-cell immunophenotype was more common in the <18 age group. Complete remission was infrequent in the >or=60 age group. The overall survival was poor for all sALL regardless of age, primary diagnoses, cytogenetic subgroups, or immunophenotype. Allogeneic transplantation most probably represents the only chance of cure.


CONCLUSIONS
Better identification of prognostic factors to prevent the occurrence of sALL is indicated.
Shivakumar
R
R
Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Tan
W
W
Wilding
G E
GE
Wang
E S
ES
Wetzler
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001707:Biopsy, Needle; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007951:Leukemia, Myeloid / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D016896:Treatment Outcome