A 12-year-old female presents to your office with hip pain and easy bruising. She does not recall any episodes of trauma and the pain has not responded to scheduled acetaminophen. She has no prior medical history and takes no other medications. She does not smoke or drink alcohol, and she is not sexually active. Her physical examination reveals a pale-appearing, well-developed female with a temperature of 38°C, pulse 100, blood pressure 90/50, and respirations of 12. Purpura is noted in her oropharynx. Her neck is supple with palpable cervical lymph nodes. Heart and lung exams are unremarkable. The abdomen is soft and nontender with a palpable spleen tip. Extremities demonstrate a few ecchymoses. Her left hip is painful with passive and active range of motion.

While you are waiting to obtain a hip radiograph, blood is drawn, and you find a WBC 60,000/mm3 with 70% lymphocytes, hemoglobin of 8.4 g/dl, and platelet count of 30,000/mm3. Immunophenotyping reveals pre-B-cell morphology, and she is diagnosed with acute lymphoblastic leukemia. You admit her to the hospital and consult the hematology/oncology team.

1		Which of the following statements is INCORRECT?
			A)	This is the least common childhood leukemia.
			B)	Due to the high rate of central nervous system involvement, she will need intrathecal chemotherapy.
			C)	Despite an overall good prognosis for acute lymphoblastic leukemia in children, her age and high WBC portend a poorer prognosis.
			D)	Due to the possibility of residual leukemic cells after induction chemotherapy, extended chemotherapy is required.
			E)	Initial response to chemotherapy will help determine the patient's overall prognosis.