Prognostic factors

The most important prognostic factors are listed below. These are useful for risk stratification to identify patients who require transplantation in first CR.

• Patient age (<50y CR >80%, LFS>30%; >50y CR <60%, LFS <20%)

• High leucocyte count (>30 x 109/L in B precursor-ALL; >100 x 109/L in T-ALL) poor risk.

• Immunophenotype: pro-B-ALL and pro-T-ALL have poorer outcomes; common pre-B-ALL still poor; mature B-cell ALL and T-cell ALL had poorer outcomes before the use of more intensive regimens, now better.

• Cytogenetics: Ph+ very poor prognosis: <10% LFS after chemotherapy; for others (fflp)59).

• High MRD level after induction (>10-3); persistent/increasing MRD during consolidation.

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