A simplified in vitro classification for prognosis in adult acute leukemia:
the application of in vitro results in remission-predictive models
G Spitzer, KA Dicke, EA Gehan, T Smith, KB McCredie, B Barlogie and EJ Freireich
Previous classification in vitro of adult acute leukemia incorporating
morphology has been complex and difficult to understand. We have devised a
simplified classification based solely on leuekemic proliferation in vitro.
Seventy-six patients with adult acute leukemia previously untreated were
included in this study and received identical chemotherapy. Three groups
were recognized. The complete remission rate was 76% in the 21 patients
with no leukemic growth in vitro (Group 1), 75% in 36 patients with
leukemic cell growth but aggregates of 20 cells or less (Group 2), and only
21% in the 15 patients with aggregates of greater than 20 (Group 3). There
was a highly significant difference in complete remission rates between
Group 3 and the other two groups (p less than 0.001). Linear logistic
regression analysis demonstrated the independence of the growth in vitro
from other prognostic variables. A predictive model utilizing the in vitro
result more accurately predicted for remission, both retrospectively and
prospectively, than a model constructed with presently known prognostic
parameters. The cause of death in failures suggested that this system
detects resistance to the chemotherapy.
Volume 48,
Issue 6,
pp. 795-807,
12/01/1976
Copyright © 1976 by The American Society of Hematology
