Outcomes after Induction Failure in Childhood Acute Lymphoblastic Leukemia

Induction chemotherapy fails to induce a complete remission in only about 2 to 3% of children with ALL. In an analysis of more than 1000 such patients, the authors defined subgroups with a favorable prognosis and those with an unfavorable prognosis. Current treatment for acute lymphoblastic leukemia (ALL) can effect a cure in approximately 80% of children with the disease. 1 – 9 The leading cause of treatment failure is relapse, for which a number of risk factors have been identified, with inadequate therapy being one of the most important. 10 – 19 A small but significant percentage of patients do not have a complete remission after 4 to 6 weeks of induction chemotherapy. 20 – 23 Among patients with initial induction failure, some never have a complete remission and most others have early relapse. Because of the rarity of induction failure, affected patients have been collectively . . .