Abstract
Acute lymphoblastic leukemia (ALL) in infants is a rare disease. Particularly babies under 6 months of age and those with a t(4;11) have a poor prognosis, early treatment failure being the rule.
The most relevant biologic risk factor portending a bleak outlook is rearrangements involving the MLL gene at 11q23 [1-7]. This promiscuous gene is involved in a number of translocations with other partner genes, of which the most frequent and possibly the most important is t(4;11)(q21;q23), i.e., the MLL/AF4 rearrangement.
On the other hand, there is a small subgroup of infants with ALL without high-risk features who may benefit from the relatively less toxic standard therapies available now. These may account for 25-40% long-term survivors.
Here we report on the outcome of 28 infants with ALL treated in 1986-1995 by members of the Czech Pediatric Hematology Working Group.