{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:00:51Z","timestamp":1773838851805,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Absolute lymphocyte counts (ALC) during treatment have been associated with outcome in children and adults with hematologic malignancies. However, the impact of ALC relative to that of other prognostic factors on the outcome of children with acute lymphoblastic leukemia (ALL) treated in recent trials is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Outcomes of 399 patients aged \u226418 years with newly diagnosed ALL who were enrolled in the Total Therapy XV study at St. Jude Children's Research Hospital were analyzed according to ALC at the end of remission induction therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>An ALC \u2265500 cells\/\u03bcL was significantly more prevalent among patients with B\u2010lineage ALL, in those with favorable presenting features, and in those who achieved negative minimal residual disease (MRD) status on day 43 of treatment. Both overall survival (OS) and event\u2010free survival (EFS) were superior among patients with higher ALC, but only the association with OS was statistically significant in a univariate analysis. In multivariable analyses, ALC was not a significant predictor of outcome after controlling for age, leukocyte count, lineage, risk group, and MRD status at the end of induction (<jats:italic>P<\/jats:italic> &gt; .1 for all comparisons). However, among MRD\u2010negative patients, those with low ALC had a 5\u2010year OS rate of 84.2% \u00b1 8.9% versus 97.3% \u00b1 1.0% for patients with higher ALC (<jats:italic>P<\/jats:italic> = .036).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>ALC at the end of induction is related to favorable presenting features and good initial treatment response but does not independently predict outcome in the context of contemporary, MRD\u2010guided therapy. Cancer 2013;119:2061\u20132066. \u00a9 2013 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.28026","type":"journal-article","created":{"date-parts":[[2013,3,2]],"date-time":"2013-03-02T02:15:51Z","timestamp":1362190551000},"page":"2061-2066","source":"Crossref","is-referenced-by-count":26,"title":["Prognostic impact of absolute lymphocyte counts at the end of remission induction in childhood acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"119","author":[{"given":"Jeffrey E.","family":"Rubnitz","sequence":"first","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinmei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T.","family":"Sandlund","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Jeha","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul C.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Inaba","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepa","family":"Bhojwani","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary V.","family":"Relling","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"},{"name":"Department of Pharmaceutical Sciences St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott C.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital Memphis Tennessee"},{"name":"Department of Pediatrics College of Medicine University of Tennessee Health Science Center Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Campana","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National University of Singapore 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