Change search
ReferencesLink to record
Permanent link

Direct link
High white blood cell count at diagnosis of childhood acute lymphoblastic leukaemia: biological background and prognostic impact. Results from the NOPHO ALL-92 and ALL-2000 studies
Centre for Paediatric Oncology and Haematology, University Childrens Hospital, Vilnius, Lithuania.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Department of Paediatrics, Ullevål University Hospital, Oslo, Norway.
Department of Paediatric Oncology, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden.
Show others and affiliations
2011 (English)In: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 86, no 1, 38-46 p.Article in journal (Refereed) Published
Abstract [en]

Prognostic impact of peripheral blood white blood cell count (WBC) at the diagnosis of childhood acute lymphoblastic leukaemia (ALL) was evaluated in a population-based consecutive series of 2666 children aged 1-15 treated for ALL between 1992 and 2008 in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). Ten-year event-free (pEFS(10 y)) survival and overall (pOS(10 y)) survival were 0.75 ± 0.01 and 0.85 ± 0.01, respectively. Although treatment intensity was determined by WBC, non-remission and relapsed patients still had significantly higher WBC than those in remission for B-cell precursor (BCP) (median WBC: 24.8 vs. 14.0 vs. 8.3 × 10(9) /L, P < 0.001), but not for T-lineage (T-ALL) (median WBC: 127.8 vs. 113.0 vs. 86.8 × 10(9) /L, P = 0.22). pEFS was inversely related to WBC for BCP (P < 0.001), but not for T-ALL. WBC was not associated with risk of event for BCP or T-ALL for patients with minimal residual disease at the end of induction (MRD(d29) ) <10(-3). In contrast, for MRD(d29) ≥ 10(-3) and <5% leukaemic blasts in bone marrow at day 29, the pEFS(5 y) for WBC < 100.0 (N = 152) vs. ≥ 100.0 (N = 19) was 0.76 vs. 0.50 (P = 0.001). That was the case both for BCP (pEFS(5 y) 0.76 vs. 0.58) and for T-ALL (pEFS(5 y) 0.71 vs. 0.38). Whether the inferior EFS for the subset of patients with high WBC and slow initial response to treatment reflects rare or overlooked cytogenetic aberrations as well as the factors that determine WBC levels at diagnosis awaits exploration.

Place, publisher, year, edition, pages
2011. Vol. 86, no 1, 38-46 p.
Keyword [en]
white blood cell; acute lymphoblastic leukaemia; children; survival; prognostic factors; minimal residual disease
URN: urn:nbn:se:umu:diva-40536DOI: 10.1111/j.1600-0609.2010.01522.xPubMedID: 21077959OAI: diva2:400476
Available from: 2011-02-25 Created: 2011-02-25 Last updated: 2011-02-28Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Forestier, Erik
By organisation
In the same journal
European Journal of Haematology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 32 hits
ReferencesLink to record
Permanent link

Direct link