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Arch Dis Child. 1989 May; 64(5): 657–661.
PMCID: PMC1792031

Treatment centre size, entry to trials, and survival in acute lymphoblastic leukaemia.


In a population based series of 4070 children with acute lymphoblastic leukaemia treated in Britain during 1971-82, the five year survival rate improved from 37% for those treated in 1971-3 to 66% in 1980-2. During the same period there was an increase in the proportion of children included in the Medical Research Council trials and an increase in the proportion who were treated at centres with an average of at least six new patients per year. Survival rates were significantly higher for children who were included in the trials than for those who were not. Among children not in the trials, the survival rate was highest at centres treating at least six children per year and lowest at those with fewer than one per year. The increase in the numbers of children treated according to standardised protocols, particularly within controlled clinical trials, has had a major impact on the mortality from childhood acute lymphoblastic leukaemia.

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Selected References

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  • Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. [PubMed]
  • Chessells JM, Leiper AD, Tiedemann K, Hardisty RM, Richards S. Oral methotrexate is as effective as intramuscular in maintenance therapy of acute lymphoblastic leukaemia. Arch Dis Child. 1987 Feb;62(2):172–176. [PMC free article] [PubMed]
  • Mott MG, Chessells JM, Willoughby ML, Mann JR, Morris-Jones PH, Malpas JS, Palmer MK. Adjuvant low dose radiation in childhood T cell leukaemia/lymphoma (report from the United Kingdom Childrens' Cancer Study Group--UKCCSG). Br J Cancer. 1984 Oct;50(4):457–462. [PubMed]
  • Meadows AT, Kramer S, Hopson R, Lustbader E, Jarrett P, Evans AE. Survival in childhood acute lymphocytic leukemia: effect of protocol and place of treatment. Cancer Invest. 1983;1(1):49–55. [PubMed]
  • Eden OB, Stiller CA, Gerrard MP. Improved survival for childhood acute lymphoblastic leukemia: possible effect of protocol compliance. Pediatr Hematol Oncol. 1988;5(2):83–91. [PubMed]
  • George SL, Aur RJ, Mauer AM, Simone JV. A reappraisal of the results of stopping therapy in childhood leukemia. N Engl J Med. 1979 Feb 8;300(6):269–273. [PubMed]
  • Chessells JM, Hardisty RM, Richards S. Long survival in childhood lymphoblastic leukaemia. Br J Cancer. 1987 Mar;55(3):315–319. [PubMed]
  • Mandelli F, Amadori S, Ceci A, Guazzelli C, Madon E, Marchi A, Masera G, Paolucci G, Zanesco L. Long-term survival in childhood acute lymphocytic leukemia in Italy. Cancer. 1981 Dec 1;48(11):2364–2367. [PubMed]

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