Acute Lymphoid Leukemia Outcomes in Black and White Children-Reply

In Reply.  —Dr Pinkel raises the interesting question of whether improved survival rates for black children treated at St Jude since 1984 might reflect improvements in nutritional status. To address this question, we determined the proportions of black children who had subnormal nutritional status (ie, body weight less than 90% of ideal, defined as the 50th percentile of weight for height in a standard growth chart^1,2). These proportions did not differ from the early treatment era to the recent treatment era (26% vs 24%; P=.99). Thus, nutritional status is unlikely to have contributed to the change in treatment outcome. Unfortunately, parental occupation and education are not routinely addressed in our admissions questionnaires, so specific comparison of socioeconomic status based on these factors is not possible.Pinkel suggests that longer follow-up is needed for outcome analysis in ALL. However, definitions of cure change with improved treatment. We have shown