XXXX : the effect of early antileukemic therapy.

@entity1 @entity4585 @entity1503 @entity3052
OBJECTIVE: To evaluate the effect of antileukemic chemotherapy administered at diagnosis on the survival of @entity1 with @entity4585 . DESIGN: Retrospective review of locally identified @entity1 and analysis of cases from the medical literature. @entity1 : The records of all @entity1 with @entity4585 identified at three teaching hospitals in Toronto between 1980 and 1994 were reviewed. A MEDLINE search was done to identify all cases of @entity4585 reported in the English-language medical literature. @entity1 with a previous known @entity1503 were excluded. MEASUREMENTS: The effect of therapy on 1) the interval between diagnosis of @entity4585 and diagnosis of @entity3052 and 2) survival was determined. RESULTS: 7 local @entity1 and 83 published cases were identified, for a total of 90 evaluable @entity1 . For the entire group, the median time to the diagnosis of @entity3052 was 9 months, and median survival was 22 months. Chemotherapy was administered to 49 @entity1 (54%) at diagnosis of @entity4585 . Significantly fewer @entity1 treated with chemotherapy subsequently developed @entity3052 (41% compared with 71%; P = 0.001). Survival was longer in @entity1 treated with chemotherapy (> 50% alive with a median follow-up of 25 months compared with a median survival of 13 months for those initially untreated; P = 0.001). Multivariate analysis showed that neither local radiotherapy nor surgery had an effect on survival. CONCLUSIONS: Administration of antileukemic chemotherapy at diagnosis of @entity4585 is associated with a significantly lower probability of developing @entity3052 and with longer survival.
