Evaluation of 216 four-year survivors of acute leukemia

Analyses of records of 216 long-term leukemia survivors disclose two types of patients-those in whom survival does not appear heavily dependent on the type of therapy or its duration and those in whom survival depends heavily on the therapeutic program of periodic reinductions. Prognosis significance of hematologic relapse and of meningeal relapse was evaluated. Early hematologic relapses because of inadequate initial therapy may leave place for hope if patients are correctly treated afterwards; late hematologic relapses in patients correctly treated from the onset of their disease are of poor prognosis. A group of nine children who developed meningeal disease during the first 2 years of their disease and are still enjoying complete hematologic remission 4 to 7 years later. Meningeal relapses occurring after the third year have a uniformly bad prognosis. Long-term survivals probably do possess, at least in the first group, host properties which we are unable to recognize and unable to take advantage of.