Childhood leukaemia: therapeutic and experimental approach.

Abstract

A summary is given of some activities of the Hungarian Study Group for Childhood Leukaemia. Coordinated efforts within the Study Group led to improved therapeutic results. The median survival of patients diagnosed in 1971 was 12 months. For a comparison, out of the 57 patients diagnosed in 1978, 34 are still in their first remission. Experimental work designed to approach the pathomechanism of the disease provided the following main points of interest. 1. Children diagnosed to have L1 type ALL according to the FAB categories fare better than those with L2. 2. ADA activity was essentially normal in patients being in remission and their parents. 3. Steroid receptor determinations can be of value in the planning of therapy. 4. Very low as well as very high initial WBC count indicates a bad prognosis. 5. Children who possess the DR 5 histocompatibility antigen have a better outlook for long complete remissions and cure. 6. Growth hormone secretion and, accordingly, growth rate was normal in the long surviving patients. 7. There was a slight impairment in the performance IQ of children who were under 6 years of age at the time of diagnosis. 8. Emotional disturbances were universal in all patients, but could be much alleviated by regular psychological care and play activity. 9. So far we observed one patient with a second malignancy: his AML manifested 4 years after the successful removal and chemo-radiotherapy of his brain tumour. 10. Children in long, continuous remission-thought to be cured of their disease-possess normal remission lymphocytes with a significantly shorter cell cycle than controls.