title: Prognostic significance of leukopenia in childhood acute lymphoblastic leukemia.
abstract: Chemotherapy-induced leukopenia has been shown to be associated with the outcomes of several types of cancer, but the association with childhood acute lymphoblastic leukemia (ALL) remains unknown. To elucidate the association of chemotherapy-induced leukopenia with the clinical outcome of childhood ALL, retrospective analysis was performed on 19 child patients with ALL treated according to the ALL-BFM 95 high-risk (HR) protocol. The mean minimum leukocyte count over the first three courses of the consolidation phase was used as the measure of hematological toxicity and ranged between 200 and 1,167/μl. The risk of relapse was significantly higher in patients with a mean minimum leukocyte count above the median of 433/μl (hazard ratio, 6.61; P=0.047). In conclusion, chemotherapy-induced leukopenia was found to correlate with relapse-free survival in childhood HR ALL. Dose escalation based on hematologic toxicity must be prospectively studied.
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shiozawa
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan ; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Takita
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama 339-0077, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Hematology-Oncology, Gunma Children's Medical Center, Shibukawa, Gunma 377-0061, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sotomatsu
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama 339-0077, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Koh
authors.affiliation: Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawasaki, Kanagawa 213-8507, Japan.
authors.forename: Kohmei
authors.initials: K
authors.lastname: Ida
authors.affiliation: Department of Hematology-Oncology, Gunma Children's Medical Center, Shibukawa, Gunma 377-0061, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Hayashi
keywords: chemotherapy; childhood acute lymphoblastic leukemia; white blood cell count