Age At Diagnosis

Most clinical trials5-9 have noted a marked difference in both complete remission (CR) rate and DFS in ALL patients, depending on patient age. Both comorbid medical conditions resulting in increased toxicity of induction and postremission therapy and the presence of higher risk biologic features contribute to the adverse prognosis of older adults with ALL. DFS is consistently less than 20% in patients older than 60 years. Shorter remission duration in older adults is also a consequence of the higher frequency of adverse cytogenetic features, including the t(9;22)(q34;q11), or Philadelphia chromosome, which may occur in as many as 40% of adults older than 50 years.10'11

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