Pretherapeutic Morbidity in the Prognostic Staging of Acute Leukemia

To classify the clinical severity of acute leukemia, we have used the degrees of pretherapeutic infection and hemorrhage to construct a taxonomy containing three "stages". The stages are associated with survival gradients that are clinically and statistically distinctive in both acute lymphoblastic leukemia and acute nonlymphoblastic leukemia. Median survival ranged from 64.0 months for stage 1 to 10.5 months for stage 3 in acute lymphoblastic leukemia, and from 7.1 months for stage 1 to 1.2 months for stage 3 in acute nonlymphoblastic leukemia. The gradients, which persist when other prognostic factors and secular therapeutic changes are taken into account, are more distinctive than those found with other forms of stratification.