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Age is an important prognostic factor in acute childhood lymphoblastic leukemia (ALL): intermediate age children (1-9 years) show a better outcome than infants (0-1 year) and adolescents (10-15 years). However recent literature data do not agree about adolescents worse prognosis. We tried to contribute to this issue with a retrospective analysis about presenting features and survival of 302 pediatric patients (65 adolescents and 237 children) with non B ALL enrolled on AIEOP protocols at the Departments of Pediatric Haematology-Oncology (University of Turin) from 1976 to 1992. The last follow up was 30.11.94. We found in adolescents, in spite of higher frequency of unfavourable prognostic factors (Hb > 8 g/dl, mediastinal mass, T cell immunophenotype, L2 morphology), an event free survival similar to children (EFS 52% vs 51%). In conclusion in our population we found that age at diagnosis greater than 10 years does not represent an unfavorable prognostic factor.

While the invasion of the bladder by neoplastic cells during acute lymphatic leukaemia in children has been reported by various authors, the leukaemic invasion of the bladder in adults is extremely rare. We report a case of recurrence of A.L.L. in the bladder presenting colicky symptomatology and obstruction of the excretory tracts.

Infantile leukemias (IL) with onset of the disease in the first year of life account for less than 5% of childhood leukemias. Twenty-four IL cases (age at diagnosis [AD] less than 1 year), treated in a single institution over a 15 year period were analyzed. IL cases were paired with elder leukemic children, matched by type of leukemia (ALL and ANLL), sex, year of diagnosis, and regional residence. For ALL 2 control groups (CG) were chosen: AD 3-6 years (CG1), corresponding to ALL incidence peak in Italy, and AD 6-14 years (CG2); for ANLL (not having age specific incidence peak): AD greater than 3 years. In ALL the main biological differences between IL and CGs are represented by initial WBC count and IgM at onset, significantly higher in IL cases (p less than 0.01 and 0.05, respectively). In ANLL a significant excess of M4/M5 morphology was found among IL (p less than 0.01). Moreover, a significantly shorter survival was found in infantile ALLs vs. CG1, in the stratum with WBC count at onset greater than 50,000/mm3 (p less than 0.05).