CLINICAL PRESENTATION, HEMATOLOGIC FEATURES AND TREATMENT OUTCOME OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA - A REVIEW OF 73 CASES IN HONG-KONG

Seventy-three consecutive cases of childhood acute lymphoblastic leuke mia (ALL) diagnosed and managed in Queen Mary Hospital over a 10-year period from 1985 to 1994 were retrospectively analysed for their prese nting features and treatment outcome. The 48 boys and 25 girls ranged in age from 0.4 to 14.2 years (median: 4.3 years). Bone and joint pain was a relatively common presenting feature besides fever, hepatosplen omegaly and lymphadenopathy. Immunophenotyping of blast cells showed: 51 B-cell precursor ALL, one B-ALL, 10 T-ALL and three myeloid-antigen positive ALL. Eight cases were unclassified since immunophenotyping h ad not been performed. Out of the 73 patients, treatment outcome was a nalysed in 20 cases treated with UKALL-VIII regimen and 28 cases treat ed with either the UKALL-XI regimen or the Hong Kong Children Cancer S tudy Group (HKCCSG) protocol which was modelled upon UKALL-XI. Althoug h complete remission rates were similar between the two groups, patien ts treated with the former regimen that was less intensified suffered more relapses than the latter (56 per cent versus 21 per cent, P=0.04) . There were, however, no significant differences both in event-free s urvival (38.2 +/- 11.2 per cent versus 71.3 +/- 9.3 per cent, P=0.12) and overall survival (70.0 +/- 10.2 per cent versus 79.6 +/- 8.3 per c ent, P=0.41) between the two groups at 3 years by log-rank test. With the use of risk-directed therapy and improved supportive care, two-thi rds of our patients are able to enjoy long-term event-free survival. ( C) 1997 John Wiley & Sons, Ltd.