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No differences in cell proliferation parameters were found between initial and relapsed AML.
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Note CSF indices did not differ between initial and relapse episode.
For the AML samples, the in vitro drug resistance did not differ significantly between initial and relapse samples, but the numbers were small in the latter group.
This may explain why the proportion of cases diagnosed on India Ink and culture were lower, and those diagnosed by CrAg higher, than prior series, and also why CSF indices did not differ between initial and relapse episodes.
However, there is evidence that the genome becomes more plastic when placed under the stresses encountered while infecting a human host, with the appearance of remarkably different electrophoretic karyotypes not only between patients, but also between initial and relapse infections of an individual (Fries et al. 1996).
Median age was 53 years (range 30 74 years), more than 70% of patients had KPS ⩾90% and the median time between initial diagnosis and relapse was 17.8 months.
The S-phase fractions, but not the expression of Ki67 or PCNA, showed differences between bone marrow vs peripheral blood samples as well as between initial vs relapsed ALL.
The median period between initial treatment and relapse was 186 days (range 11 543).
However, the time between initial diagnosis and relapse was not significant in univariate analysis.
The median interval between initial diagnosis and relapse or second primary occurrence was 14 months (range 6 53 months).
Exclusion of patients with relapse after 1999 or a second cancer from the survey and the lack of relevant information in deceased patients may have led to loss of information about patients trying to have children in the years between initial treatment and relapse, second cancer or death.
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