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The Medical Research Council acute lymphoblastic leukaemia trials (UKALL X and XI) recruited 3,702 children with ALL between January 1985 and March 1997. Seventy-nine children had central nervous system (CNS) involvement in their first two relapses. Fourteen children survived at a median follow-up of 22 months from second relapse; seven (9%) in third remission, two in later remissions and five with disease. Factors predictive of survival from second relapse were site (isolated CNS was better than combined CNS, P = 0.02) and time from diagnosis to second CNS relapse (longer time was better, P = 0.004). Prognosis after second CNS relapse is extremely poor, and palliative therapy is appropriate.


Journal article


Br J Haematol

Publication Date





787 - 789


Central Nervous System Neoplasms, Child, Child, Preschool, Clinical Trials as Topic, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Neoplasm Recurrence, Local, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Prognosis, Survival Analysis