{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:41Z","timestamp":1790380841693,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,10,13]],"date-time":"2014-10-13T00:00:00Z","timestamp":1413158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Childrens cancer group","award":["U10 CA13539"],"award-info":[{"award-number":["U10 CA13539"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Children and adolescents presenting with a markedly elevated white blood cell (<jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content>) count (<jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> \u2265200\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/l) comprise a unique subset of high\u2010risk patients with acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>). We evaluated the outcomes of the 251 patients (12% of the study population) with <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> treated on the Children's Cancer Group\u20101961 protocol. Patients were evaluated for early response to treatment by bone marrow morphology; those with a rapid early response were randomized to treatment regimens testing longer and stronger post\u2010induction therapy. We found that <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> patients have a poorer outcome compared to those patients presenting with a <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> &lt;200\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/l (5\u2010year event\u2010free survival 62% vs. 73%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b70005). Longer duration of therapy worsened outcome for <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> cell <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> with a trend to poorer outcome in <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ALL ME WBC<\/jats:styled-content> patients. Augmented therapy benefits <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> cell <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> patients, similar to the entire study cohort, however, there appeared to be no impact on survival for <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ALL ME WBC<\/jats:styled-content> patients. <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> was not a prognostic factor for <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> cell patients. In patients with high risk features, <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content> lineage disease in association with <jats:styled-content style=\"fixed-case\">ME WBC<\/jats:styled-content> has a negative impact on survival.<\/jats:p>","DOI":"10.1111\/bjh.13160","type":"journal-article","created":{"date-parts":[[2014,10,13]],"date-time":"2014-10-13T12:03:05Z","timestamp":1413201785000},"page":"533-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Increased post\u2010induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (\u2265200\u00a0\u00d7\u00a010<sup>9<\/sup>\/l) with <scp>T<\/scp> cell acute lymphoblastic leukaemia but not <scp>B<\/scp> cell disease: a report from the <scp>C<\/scp>hildren's <scp>O<\/scp>ncology <scp>G<\/scp>roup"],"prefix":"10.1111","volume":"168","author":[{"given":"Caroline","family":"Hastings","sequence":"first","affiliation":[{"name":"Department of Hematology Oncology Children's Hospital &amp; Research Center Oakland Oakland CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Gaynon","sequence":"additional","affiliation":[{"name":"Division of Hematology Oncology Department of Pediatrics Children's Hospital Los Angeles University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Nachman","sequence":"additional","affiliation":[{"name":"Section of Hematology Oncology Department of Pediatrics University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harland N.","family":"Sather","sequence":"additional","affiliation":[{"name":"Children's Oncology Group Arcadia CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Children's Oncology Group Statistics &amp; Data Center University of Florida Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Devidas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Children's Oncology Group Statistics &amp; Data Center University of Florida Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita L.","family":"Seibel","sequence":"additional","affiliation":[{"name":"Clinical Investigations Branch Cancer Therapy Evaluation Program DCTD National Cancer Institute National Institutes of Health Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.3927"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-292615"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.40.8724"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.11.2234"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.8018"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24420"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-04-1390"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950140317"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-09-112920"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808253"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.6.2222"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806043382304"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.3.920"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.2820"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1977.1"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.10461"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-01-024729"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.2514"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-02-070342"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.1.18"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980201)82:3<600::AID-CNCR24>3.0.CO;2-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12442"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.7.1508"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbjh.13160","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.13160","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T17:12:49Z","timestamp":1696353169000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.13160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,13]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1111\/bjh.13160"],"URL":"https:\/\/doi.org\/10.1111\/bjh.13160","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,13]]},"assertion":[{"value":"2014-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}