45
Views
8
CrossRef citations to date
0
Altmetric
Original Article

Clinical Importance of Speed of Response to Therapy in Childhood Lymphoblastic Leukaemia

Pages 501-506 | Received 05 Jan 1998, Published online: 01 Jul 2009
 

Abstract

Speed of response to therapy predicts outcome in childhood lymphoblastic leukaemia. This observation has been made studying both blood and bone marrow in children on widely differing treatment regimens from the 1970s to the present day. It appears to be independent of other classical prognostic factors such as age and diagnostic white cell count. Currently some major collaborative groups are using the rate of initial disease clearance to risk-stratify subsequent therapy and this practice may increase.

The best way to measure the rate of disease clearance remains to be defined. Watching disappearance of peripheral blood blasts is the least invasive method but possibly the least sensitive. Molecular quantitation of minimal residual disease (MRD) after achievement of conventional remission is much more sensitive but less specific. It cannot be applied to all patients and is costly and time consuming. The degree of marrow infiltration remaining after 7 or 14 days may fall between the two but is often difficult to estimate reliably and reproduc-ibly due to technical limitations. The three techniques may reflect response to therapy in a way slightly different from each other and may not be direct correlates. The best compromise may be to use all three but to reserve MRD study only for those who clear their blood and bone marrow after 7 days.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.