{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:02:59Z","timestamp":1791849779333,"version":"4.3.4"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2000,8,1]],"date-time":"2000-08-01T00:00:00Z","timestamp":965088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute lymphoblastic leukemia (ALL) is the most common cancer in children and is among the most curable of the pediatric malignancies. Many clinical, biological, genetic, and molecular features have been identified as having prognostic significance in the outcome of patients with ALL. The standard features are age and WBC at diagnosis, with infants (less than one year), adolescents (greater than nine years), and children with WBC above 50,000\/\u03bcl being at higher risk. Certain chromosomal abnormalities are also strong predictors; in particular, the Philadelphia chromosome and MLL gene rearrangements (especially in infants) are adverse features, while TEL-AML1 is favorable. It is important to note, however, that even the most important known predictors explain only a small proportion of the variability in outcome. These features are currently used to tailor the intensity of treatment so that the toxicity of treatment can be minimized and cure rates can continue to improve. This article reviews time-honored prognostic features, recent advances, and future directions in this field.<\/jats:p>","DOI":"10.1634\/theoncologist.5-4-321","type":"journal-article","created":{"date-parts":[[2004,8,24]],"date-time":"2004-08-24T21:38:39Z","timestamp":1093383519000},"page":"321-328","source":"Crossref","is-referenced-by-count":44,"title":["The Role of Prognostic Features in the Treatment of Childhood Acute Lymphoblastic Leukemia"],"prefix":"10.1093","volume":"5","author":[{"given":"Alison M.","family":"Friedmann","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Division of Pediatric Hematology\/Oncology, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard J.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Division of Pediatric Hematology\/Oncology, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2000,8,1]]},"reference":[{"key":"2021122209570377600_R1","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1182\/blood.V80.10.2471.2471","article-title":"Favorable outcome of B-cell acute lymphoblastic leukemia in childhood: a report of three consecutive studies of the BFM group","volume":"80","author":"Reiter","year":"1992","journal-title":"Blood"},{"key":"2021122209570377600_R2","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1200\/JCO.1994.12.4.740","article-title":"Treatment of childhood acute lymphoblastic leukemia: results of Dana-Farber Cancer Institute\/Children's Hospital Acute Lymphoblastic Leukemia Consortium Protocol 85-01","volume":"12","author":"Schorin","year":"1994","journal-title":"J Clin Oncol"},{"key":"2021122209570377600_R3","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/(SICI)1097-0142(19980201)82:3<600::AID-CNCR24>3.0.CO;2-4","article-title":"Treatment of patients with acute lymphoblastic leukemia with bulky extramedullary disease and T-cell phenotype or other poor prognostic features: randomized controlled trial from the Children's Cancer Group","volume":"82","author":"Steinherz","year":"1998","journal-title":"Cancer"},{"key":"2021122209570377600_R4","doi-asserted-by":"crossref","first-page":"4263","DOI":"10.1182\/blood.V86.11.4263.bloodjournal86114263","article-title":"High frequency of t(12;21) in childhood B-lineage acute lymphoblastic leukemia","volume":"86","author":"Romana","year":"1995","journal-title":"Blood"},{"key":"2021122209570377600_R5","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1200\/JCO.1997.15.3.1150","article-title":"TEL gene rearrangement in acute lymphoblastic leukemia: a new genetic marker with prognostic significance","volume":"15","author":"Rubnitz","year":"1997","journal-title":"J Clin Oncol"},{"key":"2021122209570377600_R6","first-page":"1985","article-title":"TEL\/AML1 fusion resulting from a cryptic t(12;21) is the most common genetic lesion in pediatric ALL and defines a subgroup of patients with an excellent prognosis","volume":"9","author":"Shurtleff","year":"1995","journal-title":"Leukemia"},{"key":"2021122209570377600_R7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1182\/blood.V67.1.135.135","article-title":"Clinical and biologic features predict a poor prognosis in acute lymphoid leukemias in infants: a Pediatric Oncology Group study","volume":"67","author":"Crist","year":"1986","journal-title":"Blood"},{"key":"2021122209570377600_R8","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0022-3476(05)83125-7","article-title":"Biology and treatment of acute lymphoblastic leukemia","volume":"124","author":"Pui","year":"1994","journal-title":"J Pediatr"},{"key":"2021122209570377600_R9","first-page":"568a","article-title":"Ethnicity and survival following childhood actute lymphoblastic leukemia (ALL): follow-up of the Childten's Cancer Group (CCG) cohort","volume":"18","author":"Bhatia","year":"1999","journal-title":"Proc ASCO"},{"key":"2021122209570377600_R10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1200\/JCO.1996.14.1.18","article-title":"Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic lymphoma","volume":"14","author":"Smith","year":"1996","journal-title":"J Clin Oncol"},{"key":"2021122209570377600_R11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1365-2141.1981.tb02704.x","article-title":"Immunologically defined subclasses of acute lymphoblastic leukemia in children: their relationship to presentation features and prognosis","volume":"48","author":"Greaves","year":"1981","journal-title":"Br J Haematol"},{"key":"2021122209570377600_R12","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1182\/blood.V76.3.489.489","article-title":"Philadelphia chromosome positive childhood acute lymphoblastic leukemia: clinical and cytogenetic characteristics and treatment outcome. 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