Children with acute lymphoblastic leukemia who are at risk of induction failure tend to have certain high-risk features, a German study found. Risk factors for induction failure are older age, high leukocyte count, 11q23 rearrangement, T-cell phenotype and Philadephia chromosome, the researchers report in the New England Journal of Medicine. Allogeneic stem-cell transplantation from matched, related donors improved survival in patients with T-cell leukemia, while chemotherapy alone improved survival in children younger than 6 years with precursor B-cell leukemia and no adverse genetic features, the researchers found.

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