Early death in acute leukemia in children.

Therapy for acute leukemia in children has improved dramatically in recent years so that early death is rare. A subset of patients with extreme elevation of the WBC at diagnosis have been noted to have a higher rate of early death. We reviewed our experience with acute leukemia in children retrospectively over a 10 year period to assess the incidence and outcome of this problem. Nine early deaths occurred in a total of 185 cases (4.9%). One hundred and sixty patients presented with WBC less than 100,000/mm3 at diagnosis and four (2.5%) early deaths occurred. Twenty-five patients presented with WBC greater than 100,000/mm3 at diagnosis and five (20%) early deaths occurred (p less than 0.001). While early death in acute leukemia in children is uncommon (4.9%), patients with extremely elevated WBC at diagnosis have a significantly higher risk of early death.