The deqree of FAS positivity was determined by counting 200 hlast cells in the initial bone marrow specimen of 38 childrendm ALL. Each cell was scored on a 0 to 5 scale accordinq to the number of PAS-psitive qranules per cell (0-4). or the presence of 1 or more larqe blocks per cell (5). The patients were stratified into 3 groups accordinq to their mean PAS score. Fourteen children had a low score (mean 65, ranqe 3-150), 12 were intermediate (mea~. 315, range 153-4451. and 12 were high (mean 692, range 465-860). The mean white blood count (WBC) at diaanosis was higher in the low-score qroup compared to the hiqh-score qroup, but thedf* erence was not siqnificant (mO.05); 5/14 low-score patients had an initial WBC below 20,000/mn3, and 3/12 high-score patientsww above 20,000/mm3. There were no sir~nificant differences among tha groups with respect to aqe, h-lobin and platelet levels at* nosis or presence of a mediastinal or abdominal mass. However, 13 of 14 lw-score patients were male, compared to 4/12 and 6/12 in the intermediate and high groups (p<0.05). In addition, 7 of 13 low-score patients were in relapse by 6 months from diaqnosis (yl had an initial WBC below 20,000/mm3), compared to none of the k d z~ mediate and only 1 of the high patients (~(0.05). These results suggest that a low PAS score is related to a poor proqnosis in childhood ALL, regardless of the level of the initial WBC. Fenales tend to have higher PAS scores than males, and also seem to have a better prognosis.
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