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PubMed2004

Myoglobin--a marker of reperfusion and a prognostic indicator in patients with acute myocardial infarction.

BACKGROUND: Early noninvasive identification of patients with occluded infarct-related arteries after thrombolysis has important prognostic and therapeutic implications. Recent reports indicate that plasma kinetics of cardiac marker proteins could be very useful in diagnosis of myocardial reperfusion. Although angiographic assessment remains the ideal procedure for determining patency, it is expensive, invasive, not within the reach of most patients in developing countries, and the long-term follow-up data are still sparse. HYPOTHESIS: The present study was undertaken to investigate whether plasma kinetics of myoglobin in conjunction with clinical markers and another biochemical marker, creatine kinase, could be used to predict myocardial reperfusion more accurately and to investigate the correlation between myoglobin release after thrombolysis and mortality in patients with acute myocardial infarction (AMI) over a follow-up period of 18 months. METHODS: Eighty-three consecutive patients with AMI receiving streptokinase treatment were studied for plasma kinetics of myoglobin in conjunction with clinical markers and creatine kinase to predict reperfusion and were followed for a period of 18 months. RESULTS: Increased baseline mean +/- standard deviation levels of myoglobin were observed among "nonresponders" to streptokinase treatment compared with "responders" (469 +/- 386 microg/l vs. 270 +/- 211 microg/l). There was significantly more release of myoglobin following thrombolytic treatment among the responders than among the nonresponders (mean ratio of myoglobin levels at 90 min to 0 min 6.01 +/- 9.2 vs. 1.03 +/- 0.64). In a follow-up of 61 patients over a period of 18 months, 31% mortality was observed in the nonresponder group compared with 11.7% in the responder group. In responders, the mean ratio of myoglobin levels at 90 and 0 min was significantly less among those who died (p = 0.019) than among those who survived. CONCLUSION: A myoglobin release profile in combination with other clinical markers offers inexpensive, noninvasive, and a reasonably reliable way of assessing coronary artery patency after thrombolytic treatment.

Adult↗
PubMed1995

Laser Doppler velocimetry and platelet-derived growth factor as prognostic indicators for the healing of ulcers and ischaemic lesions of the lower limb.

The prognostic potential of skin blood flow measured by laser Doppler and serum platelet-derived growth factor (PDGF) levels was evaluated in patients with ischaemic lesions or ulceration of the lower limb. The laser Doppler-derived skin blood flow and perfusion pressure were measured in 93 patients with ischaemic lesions or ulceration in 98 lower limbs. Of these lesions, 61% healed spontaneously or with conservative local therapy, while 39% required major surgery. The likelihood for healing was reduced by older age. Comparison of receiver operating curves demonstrated that the optimal sensitivity and specificity were obtained for a combination of skin blood flow and perfusion pressure measured at 44 degrees C rather than at room temperature. If the skin perfusion pressure and blood flow were greater than 15 mmHg and 100 U respectively at 44 degrees C, 91% lesions healed, while if they were less than these values none healed. This provided a sensitivity and specificity of 100% and 83% respectively. The serum PDGF concentration was measured by radioimmunoassay in 48 patients with ischaemic lesions or ulceration of the lower limb, and compared with that in 34 healthy controls and 15 patients who had undergone abdominal surgery 3-5 days previously. The median PDGF level in the control group (83 pmol/l) was significantly less than that in the post-laparotomy group (217 pmol/l). The median PDGF level in the 31 patients whose ulcers healed with conservative therapy (210 pmol/l) was significantly higher compared with that in the 17 patients with unhealed ulcers (70 pmol/l).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Serum monoamine oxidase (MAO) as a prognostic indicator in chronic active hepatitis. II].

Aim of this study was to evaluate the prognostic value of sMAO activity, assayed by benzylamine colorimetric method. Has been studied the correlation between clinical signs of portal hypertension (splenomegaly, ascites and varices) and sMAO levels; there was a significant increase of enzyme activity in chronic active hepatitis (CAH) with splenomegaly vs. CAH without, and in liver cirrhosis (LC) with splenomegaly and/or varices vs. LC without; there was also a correlation between sMAO and gamma-globulins levels in CAH and not in LC patients. In conclusion has been discussed the prognostic value of sMAO activity in CAH.

Colorimetry↗
PubMedDate not supplied

Ischemia during ambulatory monitoring as a prognostic indicator in patients with stable coronary artery disease.

OBJECTIVE: To assess long-term prognostic significance of transient ischemia in patients with documented coronary artery disease and stable symptoms and to examine the relation between transient ischemia and the site of angiographic disease progression following acute cardiac events. DESIGN: Cohort study with a mean+/-SD follow-up of 51.5+/-23.8 months. SETTING: Ambulatory patients with stable coronary artery disease, assigned to medical therapy. PATIENTS: A total 221 patients (173 men; mean age, 60.8 years) were recruited. Of the 221 patients, 101 (45.7%) had single-vessel, 86 (38.9%) had 2-vessel, and 34 (15.4%) had 3-vessel disease. A total of 135 had a positive exercise test for ischemia, and mean+/-SD resting left ventricular ejection fraction (LVEF) was 49.8%+/-11.4%. Using conventional criteria, patients were prospectively stratified as low risk for continued medical therapy (single-vessel disease, 2-vessel disease with negative exercise test, or LVEF> or =40%; n=189 [85.5%]) or high risk for continued medical therapy (multivessel disease with ischemia and/or left ventricular dysfunction; n=32 [14.5%]). INTERVENTIONS: Ambulatory ST-segment monitoring, treadmill exercise testing, radionuclide ventriculography, and coronary angiography. MAIN OUTCOME MEASURES: Demographic, clinical, ambulatory monitoring, treadmill exercise, and left ventricular function variables as independent predictors of acute (cardiac death, myocardial infarction, or unstable angina) or all (including revascularization) cardiac events in the overall and the low-risk population. RESULTS: None of the clinical or noninvasive measures of ischemia were of prognostic significance in the overall or the low-risk group. The only significant independent predictor of outcome in all patients for all events, including revascularization, was the number of diseased vessels (X2=13.5 [df=1]; P<.001). Exclusion of vessel disease resulted in conventional risk stratification as the most significant predictor of outcome from all events in all patients (X2= 10.3 [df= 1]; P=.001). In the low-risk group, the number of diseased vessels was the only predictor for all events (X2=4.6; P=.03). For acute cardiac events, none of the variables tested were of prognostic significance. Based on the frequency of events in the low-risk patients, a 2-fold increase in the rate of cardiac events in patients with transient ischemia compared with those without transient ischemia during ambulatory monitoring could be excluded with greater than 85% power and alpha of .05. Of 30 patients suffering acute nonfatal cardiac events during follow-up, angiography was performed in 27, revealing significant progression of coronary disease in 24 (88.8%) and the development of new significant lesions at sites remote from previously significant lesions in 20 (74%) cases. These new lesions were equally likely to occur in those with or without transient ischemia at initial assessment. CONCLUSIONS: Acute cardiac events in predominantly low-risk stable angina patients with confirmed coronary disease are unpredictable, and those more likely to suffer such an event cannot be identified by the detection of ambulatory ischemia. Acute nonfatal cardiac events result predominantly from the development of significant new coronary lesions, not initially severe enough to cause ischemia. Patients categorized as high risk for long-term medical therapy have an increased rate of cardiac events (mainly revascularization) when compared with low-risk patients.

Aged↗
PubMed1990

Comparison of the predictive power of different prognostic indices for overall survival in patients with advanced ovarian carcinoma.

Validation of a 5-covariate prognostic index (PI5) (performance status, stage, residual tumor size, histological grade, and ascites) derived from a group of 268 Dutch patients with advanced ovarian carcinoma was performed in a similar study of 301 Danish patients. Analysis of survival suggested an alternative 4-covariate PI (performance status, residual tumor size, age, weight/body surface) for the latter group. As residual tumor size and performance status were common to both indices, the predictive power of this 2-covariate PI (PI2) was also assessed in the Danish study and, subsequently, validated in the Dutch patients. The PI5 defined 10 and 9% of the Dutch patients as low and high risk patients with 3-year survival rates of 80 and 8%, respectively. In the Danish study the PI5 classified 14% to be high risk patients with a 3-year survival rate of 18%. Only a few patients (3%) were classified as low risk, making comparisons irrelevant. The PI2 classified 33 and 26% of the Danish patients as having 3-year survival rates of 67 and 13%, respectively. The corresponding Dutch PI2 values were 41 and 15% of the patients with 3-year survival rates of 60 and 8%, respectively. Although the PI5 possessed a better validity in the Danish study than the PI2 in the Dutch study, the PI2 may be the best prognostic index available for general use.

Analysis of Variance↗
PubMed2000

Conventional tumor markers are prognostic indicators in patients with head and neck squamous cell carcinoma.

We tested for squamous cell carcinoma-related antigen (SCC), carcinoembryonic antigen (CEA), ferritin, immunosuppressive acid protein (IAP) and sialic acid in the serum from 247 patients with head and neck squamous cell carcinoma prior to therapy. Significant correlations were found between IAP and tumor size, lymph node metastasis, and clinical stage (P<0.0001, P<0.001, and P<0.0001). Also, sialic acid and SCC were also correlated with tumor size, lymph node metastasis, and clinical stage. Moreover IAP, sialic acid and SCC were strongly associated with survival rate (P<0.0001, P = 0.0230 and P = 0.0159). A multivariate Cox proportional hazard model demonstrated that being positive for IAP was an independent predictor for patients with H&NSCC (P = 0.0115). The results indicate that IAP, sialic acid and SCC are useful as prognostic factors.

Antigens, Neoplasm↗
PubMed1994

[Peak fibrinogen level as a prognostic indicator in acute biliary pancreatitis].

Early prediction of acute pancreatitis outcome is based on clinical classifications, but their complexity is limiting factor. The aim of this study was prospective, dynamic evaluation of plasma fibrinogen (Fb) concentration in acute pancreatitis and testing preselected, single Fb value as predictor of pancreatic and systemic complications. Serial measurement of Fb was done in 64 patients with acute biliary pancreatitis. Peak concentration of Fb was 5.93 +/- 1.08 g/L and was found 5-8 days following onset of the disease. The peak concentration differentiated patients with mild and complicated course of pancreatitis (5.68 +/- 1.00 g/L vs 6.31 +/- 1.10 g/L; p < 0.05), with the 67% sensitivity and 72% specificity. Similarly, Ranson's score distinguished mild from complicated form of pancreatitis (1.7 +/- 1.1 vs 2.6 +/- 1.3 points; p < 0.01), with the 58% sensitivity and 73% specificity. These data indicate that peak Fb concentration is useful as a single prognostic factor in acute biliary pancreatitis.

Acute Disease↗
PubMed2006

Intensity of androgen and epidermal growth factor receptor immunoreactivity in samples of radical prostatectomy as prognostic indicator: correlation with clinical data of long-term observations.

PURPOSE: We analyzed the potential prognostic significance of the immunohistochemical expression of androgen and growth factor receptors determined in prostatectomy specimens of patients with prostate cancer. MATERIALS AND METHODS: A cohort of 211 patients with locally confined prostate cancer treated with radical prostatectomy with or without antiandrogen pretreatment between January 1, 1990 and August 31, 1996 was observed prospectively. Prostatectomy samples were processed immunohistochemically to visualize androgen and growth factor receptors, of which immunoreaction intensity was scored relative to that of positive control tissue. Clinical postoperative data were processed using the Kaplan-Meier method, log rank test, and univariate and multivariate explorative Cox modeling to evaluate the contribution to overall and relapse-free survival. RESULTS: There were statistical dependencies between the androgen receptor and epidermal growth factor receptor staining indexes. Following data stratification according to the epidermal growth factor receptor staining index the prognosis associated with a low androgen receptor staining index was worse than that with a higher androgen receptor staining index. Cox regression analysis for relapse-free survival confirmed that the risk factors low androgen receptor and increased epidermal growth factor receptor staining were associated with significantly increased relative risk. Univariate Kaplan-Meier analysis showed that patients with grade 3 carcinoma had a worse prognosis than those with better differentiated carcinoma, whereas antiandrogen pretreatment had no influence on overall survival or relapse-free survival. CONCLUSIONS: Using a multivariate proportional hazards regression model for data on a cohort of 211 patients with 68 showing relapse/progress or death from disease a low intensity of androgen receptor staining indicated a poor prognosis.

Adult↗
PubMed1994

Preoperative carcinoembryonic antigen level as a prognostic indicator in resected primary lung cancer.

The aim of this study was to evaluate the prognostic significance of elevated preoperative carcinoembryonic antigen (CEA) levels in cases of resected primary lung cancer. Between 1985 and 1989, 152 patients with tumors and CEA levels above 10 ng/mL underwent operation. One hundred twenty-five of them underwent resection of their tumors and the other 27 underwent exploratory thoracotomy only. Fifty-two percent of cancers were adenocarcinomas and 33% were epidermoid. Forty-two resected tumors were classified as stage I, 29 as stage II, 45 as stage IIIa, 7 as stage IIIb, and 2 as stage IV. The 3-year actuarial survival rate was 54% for patients with stage I tumors, 28% for those with stage II, 18% for those with stage IIIa, 44% for those with stage IIIb, and 0% for those with stage IV tumors. The 5 year actuarial survival was 40% for those with stage I tumors, 28% for those with stage II, 7% for those with stage IIIa, and 0% for those with stage IIIb tumors. Preoperative CEA levels increased from stage I to stage IIIa (p < 0.05). However, based on preoperative CEA levels we were not able to predict resectability, because levels were not significantly different between stage IIIa and exploratory thoracotomy-only groups. Adenocarcinoma was not significantly associated with higher CEA levels than was epidermoid, except in stage IIIa disease (p < 0.05). We found a critical unfavorable level of prognostic significance at 30 ng/mL.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed2002

Hepatic metastases from an unknown primary neoplasm (UPN): survival, prognostic indicators and value of extensive investigations.

AIM: The objectives of this study were to identify prognostic features for patients with hepatic metastases and unknown primary neoplasms (UPN), determine the common primary tumours, assess the value of diagnostic tests in finding these tumours, and evaluate the impact of therapy and knowledge of the primary tumour on patient survival. MATERIALS AND METHODS: Eighty-eight patients with UPN and liver biopsy proven hepatic metastases over a 10-year period were reviewed (M:F, 58:30; age range 27-91 years, median 64.5 years). Histopathology, diagnostic investigations and success at identifying the primary neoplasm were recorded. In addition, in 70 patients with adenocarcinoma histology (M:F, 48:22; age range 27-91 years, median 65 years), treatment and survival data from the date of biopsy were recorded. RESULTS: The histological spectrum included adenocarcinoma in 70, neuroendocrine in four, squamous cell carcinoma in four, small cell carcinoma in four, carcinoid in two, hepatoma in one and three others. Extensive investigation identified a primary neoplasm in 16/88 patients (18%) including colorectal in six, gastric in two, lung in four, oesophageal in two, prostate in one and carcinoid in one. In the adenocarcinoma group survival data were available for 62/70 patients. Sixteen of 62 patients received active treatment with either surgery, chemotherapy, radiotherapy or a combination protocol. Forty-six of 62 patients received palliative care alone. Median survival for the adenocarcinoma group overall was 49 days. The median survival for treated patients (49 days) versus untreated patients (52 days) was not significantly different (P=0.128). Patients <65 years were more likely to receive active treatment than those >65 years (P=0.006). Age with a hazard ratio (HR) of 1.01 (P=0.178), active treatment (HR=0.65;P=0.194), knowledge of the primary neoplasm (HR=0.60;P=0.213) and male gender (HR=0.88;P=0.642) had no significant effect on survival. CONCLUSION: Although hepatic metastases are associated with poor prognosis, it is essential that a liver biopsy be performed to obtain a histological diagnosis. Adenocarcinoma metastases carry a dismal prognosis, and no prognostic factors, including knowledge of the primary tumour, are significant for patient survival. Extensive investigation is not warranted in patients with adenocarcinoma liver metastases.

Adenocarcinoma↗
PubMed2004

CLIP score as a prognostic indicator for hepatocellular carcinoma: experience with patients in the Middle East.

OBJECTIVE: To assess the prognostic ability of the Cancer of the Liver Italian Programme (CLIP) score and compare it with the Okuda system in patients with hepatocellular carcinoma from the Middle East, where the majority (70%) present with intermediate or advanced stages of the disease and do not receive any tumour-specific treatment. METHODS: The medical records of 145 patients (113 males; mean age, 58.8 +/- 12.2 years) diagnosed with hepatocellular carcinoma over a 6-year period were reviewed and the disease was staged according to the CLIP and Okuda systems. The survival was compared by Kaplan-Meier curves and Cox regression analysis. RESULTS: The overall median survival of patients with hepatocellular carcinoma was 8.3 months (95% confidence interval, 6.6-9.4). The median survivals for CLIP score 0, 1, 2, 3 and 4-6 were 35, 29, 9, 6, and 2 months, respectively; for Okuda stages I, II and III, they were 24, 9 and 4 months, respectively. The CLIP system was judged to be statistically more efficient and consistent than the Okuda in predicting survival in the Cox proportional hazard model. CONCLUSIONS: These data from patients with hepatocellular carcinoma in the Middle East suggest that the CLIP score is more reliable than the Okuda system in predicting survival and can be used efficiently to determine prognosis in patients who present with intermediate or late stage of the disease.

Adult↗
PubMed1991

Classic and modern prognostic indicators in renal cell carcinoma. Review of the literature.

The value of classic and modern prognostic factors in renal cell carcinoma as reported in the literature is determined in a review. Tumor stage is the most important single independent prognostic factor. The presence or absence of distant metastases is highly prognostic and presence of lymph node metastases is of higher prognostic value than the presence of renal vein invasion. For each given tumor stage tumor grade (especially nuclear grade) is the most reliable additional independent prognostic factor predicting patient survival. The significance of DNA cytometry as an independent prognostic factor is less clear, though it might be useful in combination with nuclear grading. Patient-related potential prognostic factors such as age, sex and serologic parameters are of lesser, if any, importance. In the future, data from molecular analysis on oncogenes and suppressor genes are likely to provide additional prognostic information.

Carcinoma, Renal Cell↗
PubMed2001

DNA and cell cycle analysis as prognostic indicators in breast tumors revisited.

Both DNA ploidy and S-phase ploidy are promising prognostic factors for node-negative breast cancer patients. Based largely on the analysis of one large study, much of the reported problems with these factors have been caused by some unappreciated complexities in categorizing DNA ploidy into low- and high-risk groups and the lack of some necessary adjustments to eliminate unwanted correlations between DNA S-phase and ploidy. When both DNA ploidy and S-phase are compensated properly, they become independent prognostic markers, forming a powerful prognostic model.

Breast Neoplasms↗
PubMed1995

Computerized axial tomographic scan measurements as prognostic indicators in patients with cervical carcinoma.

This retrospective study of 56 patients with carcinoma of the uterine cervix treated with radical radiotherapy at the Royal Marsden Hospital, London, examined whether simple measurements of maximum tumour dimension from computerized axial tomographic (CT) scans have any prognostic significance. Our results indicate that tumour depth (i.e. maximum antero-posterior dimension) of 4 cm or more is associated with a statistically significant increased relative risk of death of 2.4 (95% CI 1.1-5.5; p = 0.045), as compared with tumours with a depth of less than 4 cm. In addition, there was a clear correlation between tumour depth and lymph node involvement (r = 0.36; p < 0.01), and tumour depth and width (r = 0.70; p < 0.005). We suggest that a measurement of maximum tumour depth from the staging CT scan in these patients provides valuable additional information about likely occult lymph node metastases and prognosis, over and above that suggested by the FIGO staging system alone.

Adult↗
PubMed2003

Binet's staging system and VH genes are independent but complementary prognostic indicators in chronic lymphocytic leukemia.

PURPOSE: Rai's and Binet's staging systems have contributed significantly to the identification of major prognostic groups in chronic lymphocytic leukemia (CLL), though they fail to accurately predict disease progression at the individual level. Biologic factors, such as the mutational status of the immunoglobulin heavy-chain variable genes (VH, cytogenetics, CD38 expression, and some serum markers, have recently improved prognostic assessment in CLL. In this study, we analyzed the prognostic value of VH mutational status within the different stages of Binet's classification in 145 patients. PATIENTS AND METHODS: Our series consisted of 83 VH mutated (MT) and 62 VH unmutated (UM) patients. MT cases predominated within Binet's stage A (70%), whereas UM cases predominated among stages B and C (62%). RESULTS: Median overall survival (OS) was 84 months for UM patients and was not achieved for the MT group (70% 12-year survival, P <.0001). Concerning Binet's stage A, both median OS and progression-free survival were significantly shorter for UM patients when compared with those of MT patients (97 months v not achieved, P =.0017; and 42 v 156 months, P <.0001), which compared favorably with the classical A' and A" substaging. The VH mutational profile could also segregate stage B and C patients into two groups with different survival patterns (median OS, 78 v 120 months for UM and MT patients, respectively; P =.002). CONCLUSION: The significant survival differences observed between the VH mutational groups, among stage A and stage B and C patients, indicate that Binet's classification and VH genes are independent prognostic variables and are most likely complementary.

Brazil↗
PubMedDate not supplied

Preoperative CEA and TAG-72 serum levels as prognostic indicators in resectable gastric carcinoma.

We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p < 0.01) in patients with stage I tumors (2.9 +/- 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 +/- 6.8 ng/ml; stage III-IV: 6.8 +/- 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 +/- 1.8 U/ml) and stage II and stage III-IV (30.4 +/- 20.7 U/ml and 26.1 +/- 9.7 U/ml, respectively) (p < 0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 +/- 20.1 U/ml and 23.1 +/- 9.4 U/ml, respectively) than in well differentiated tumors (4.4 +/- 0.9 U/ml) (p < 0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p < 0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.

Adenocarcinoma↗
PubMed2005

Cyclooxygenase-2 and p53 expression as prognostic indicators in conventional renal cell carcinoma.

The aim of this study was to investigate the relationship of cyclooxygenase (COX)-2 and p53 expression with prognosis in patients with conventional renal cell carcinoma (RCC). Formalin-fixed, paraffin-embedded tissue sections of conventional RCC from 92 patients, who had undergone radical nephrectomy, were examined for COX-2 and p53 expression by immunohistochemistry and compared with clinicopathological variables. The COX-2 expression significantly correlated only with tumor size (p=0.049), whereas the p53 expression profoundly correlated with the TNM stage (p=0.024), M stage (p=0.001), and metastasis (synchronous or metachronous; p=0.004). The COX-2 overexpression did not significantly associate with p53 positivity (p=0.821). The survival rate of patients correlated with the p53 expression (p<0.0001) but not with the COX-2 expression (p=0.7506). Multivariate analyses indicated that tumor size, M stage, and p53 expression were independent prognostic factors for cancer-specific survival. The COX-2 expression was not an independent factor. These results show that the increased expression of p53 was associated with metastasis and a worse prognosis in conventional RCC, which suggests that p53 might have played an important role in the progression of conventional RCC. The increased expression of COX-2 was associated only with tumor size, but may not be an important prognostic factor in conventional RCC. No association was observed between COX-2 overexpression and p53 positivity in conventional RCC.

Biomarkers, Tumor↗
PubMed1995

Leukocyte glucose 6 phosphate dehydrogenase (G6PD) as prognostic indicator in children with acute lymphocytic leukemia.

G6PD activity, estimated in 37 patients with acute lymphocytic leukemia (ALL) prior to therapy was found to be significantly decreased in 78.37% of the patients with ALL while it was normal in other patients. Variation in G6PD was found to be dependent on the percentage of myelocytes. Correlation analysis of leukocyte G6PD activity with karyotype indicated that patients with normal karyotype with normal G6PD activity had good prognosis while those with abnormal G6PD with abnormal karyotype had poor prognosis. Subjects with normal karyotype and abnormal G6PD and vice versa had intermediate prognosis. Thus the results clearly indicate that leukocyte G6PD may be used as a diagnostic and prognostic tool.

Child↗