Prognostic significance of lymphocyte recovery in children with standard and high-risk precursor B acute lymphoblastic leukemia
Bibliographic record
Abstract
The primary aim of this study was to determine if absolute lymphocyte count (ALC) at end of induction is an independent prognostic marker of event free survival (EFS) in children with precursor B-ALL. This is a retrospective analysis of children (aged 1–18 years) diagnosed with standard and high-risk precursor B ALL. At day 29 of induction ALC (ALC29) ≥ 1.5 × 109/L was considered high and <1.5 × 109/L was considered low. Total 260 children with (183 standard risk and 77 high risk) Precursor B ALL were included. The mean age of the study cohort was 5.2 ± 4.0 years. Fourteen patients had an event (12 relapse, 4 deaths). Mean follow-up duration was 41 months ± 20 months (median 41 months). Overall survival (OS) of the entire study cohort was 98.5% (standard risk 99.4%, high risk 96.1%, p = 0.045). EFS of the entire study cohort was 94.6% (standard risk 96.1%, high risk 90.9%, p = 0.072). ALC at any of the studied time points did not correlate with relapse. MRD at day 29 was the strongest predictor of both death (p = 0.00) and relapse (0.034). ALC29 did not differentiate EFS among MRD negative patients. However, once patients relapsed, the OS was 100% for those who had ALC>1.5 × 109/L at day 29 of initial induction chemotherapy vs 40% for those with ALC <1.5 × 109/L (p = 0.01). We conclude that ALC29 cannot be used to risk stratify children with pre B ALL.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".