PEDIATRICS Vol. 10 No. 1 July 1952, pp. 48-59
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PROGNOSIS FOR SURVIVAL IN THE LEUKEMIAS OF CHILDHOOD

Review of the Literature and the Proposal of a Simple Method of Reporting Survival Data for These Diseases

HAROLD TIVEY M.D.1

1 The Division of Experimental Medicine, Department of Medicine, University of Oregon Medical School, Portland, Ore.

To establish a base line of prognosis for the "untreated" child with leukemia, the available literature on survival in leukemia has been reviewed. The applicable review articles (1927 to 1950), reporting a total of 428 cases of leukemia, have been analyzed.

It is demonstrated that the "average survival" of patients with leukemia is a misleading indication of both the most probable time of survival and the midpoint of the series.

The application of the simple, statistical technic of summarizing survival data on log-probability paper is demonstrated for the applicable series and is recommended for future reporting of similarly distributed survival data.

From these analyses, the physician can expect that 50% of the children with acute leukemia, given supportive therapy not including antibiotics, will die within a period of approximately 4 months after the onset of the first definitive symptoms. The remainder of his patients with leukemia will live considerably longer, about 10% for as long as 11 months. He can expect the middle two-thirds of his patients to survive from approximately 2 to 8 months. Thus, while there is no evidence of a definitive cure for leukemia, in many cases therapy should be planned to extend over a period of months, not merely days or weeks.

There are at this time insufficient data from which to evaluate the effects of cortisone, ACTH or antifolic acid compounds on the life expectancy of the patient with leukemia.

There is no evidence available to indicate that the prognosis in patients with granulocytic or monocytic leukemias of childhood differs from that of those with the more common lymphocytic leukemia. There is no evidence to prove that it is identical. More information is needed.

Submitted on October 21, 1951




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