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Long-term results in the treatment of 116 patients of acute lymphocitic leukemia with ages between six months and seven years are reported. A first group A, formed by 76 patients, was treated with prednisone and vincristine as induction protocol and maintenance therapy with 6-mercaptopurine or methotrexate. No neuromeningeal prophylaxis was made, except some cases in which intratecal methotrexate was applied. 27 patients are alive, 21 of them (27,6%) remain in complete remission for more than three years. A second group B, formed by 40 patients, was treated more recently; with an induction protocol composed by prednisone, vincristine and L-asparaginase. All patients in this group received cranial irradiation and intratecal methotrexate. 31 patients are alive (77,5%), 13 of them (32,5%) remain in complete remission for more than two years. The evolution period in this group B is shorter, but some features are exposed which suggest the possibility of long-term better results.

Study on 34 children among two and five years old affected by L.L.A. and 37 with different kind and differently localizated tumours is presented. Children affected by L.L.A. are distributed in two groups which followed a different therapeutical attitude. Clinics, cytochemistry, evolution and survival possibilities as well as the response to different therapy and inversion of L.L.A. relation with tumours during the last years.

Unlabelled: Sixty-one children with ALL were treated between 1970 an 1973 according to a scheme including: a) Remission induction with vincristine-prednisolone-daunorubicine. b) Cytoreduction therapy with 4 drugs (6-MP, MTX,Ara-C and CYCLO) combined two by two in 3 types of associations given at three months cycles. Every three months, two-week "reinductions" with vincristine and prednisolone plus one dose of i.t. MTX. c) Early therapy on CNS, according to two patterns: one group received one dose of i.t. MTX after induction, repeated every 3 months; the other group was given cranial irradiation [2,400 r] plus 5 doses of i.t. MTX. d) After three years of chemotherapy, patients were treated for two more years with BCG by scarification., Results: Complete remission was achieved in 93%. After three years of chemotherapy, 37% of the first group (not irradiated) and 55% of the second (irradiated) persisted in C.R. Twenty-five patients initiated BCG-therapy; eighteen of these (72%) persisted, after 2 years, in C.R.; then all treatment was suppressed. Initial relapses in the 5 years period were hematological in 13, CNS in 13, both hematological and CNS in 2, and testicular in 3. Mortality of patients in C.R. was 4 (7.7%). Survival rates were 33% after 5 years for the non-irradiated group and 50% in the irradiated one. At present, 30% of all evaluable patients who attained remission continue in C.R. after an average time of 102 months-40% in the irradiated group and 20% in the not irradiated-. This difference, statistically significant, is due to the number of CNS relapses: 13 of 30 (43%) in the first group and 3 of 22 (13.1%) in the second. The 24% relapses occurring during immunotherapy do not permit to assess the efficacy of this form of therapy.

The prognosis of patients with chronic lymphocytic leukemia is very difficult to evaluate. The classification system by stages, which at the present time is the most simple and useful method for the prognosis of this disease, recognizes five degrees of involvement: stage 0 (medullary and peripheral lymphocytosis); stage I (lymphocytosis + enlarged lymph nodes); stage II (lymphocyosis + hepato-and/or splenomegaly); stage III (lymphocytosis + anemia), and stage IV (lymphocytosis + thrombocytopenia). In the present report 95 controlled patients at the Farreras Valentí School of Hematology are analyzed using the classification by stages; there were 19 cases in stage 0; 16 in stage I; 30 in stage II; 21 in stage III, and 9 in stage IV. The mean survival rate in the global series was 63 months and the average 90.9 months. As in other series, it was observed that patients in stages 0 and I have a much better prognosis than those in stages III and IV. Stage II occupies an intermediate position in relation to prognosis, since the actuarial survival figure for this stage can practically be superimposed on that of the global series. The classification of chronic lymphocytic leukemia by stages permits the specification of the therapeutic indications for this condition; it also encourages the search for new modalities of treatment for stages with poor prognosis, since in these cases chronic lymphocytic leukemia behaves in the manner of an acute or subacute hemopathy.