An integrated evaluation of socioeconomic and clinical factors in the survival from childhood acute lymphoblastic leukaemia: a study in Greece
An integrated evaluation of socioeconomic and clinical factors in the survival from childhood acute lymphoblastic leukaemia: a study in Greece
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DOI：
10.1097/00008469-200410000-00007
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发表时间：
2004-10-01
影响因子：
2.4
通讯作者：
Trichopoulos, D
中科院分区：
文献类型：
--
作者：
Charalampopoulou, A;Petridou, E;Trichopoulos, D
社会经济因素在白血病儿童生存中的作用的评估，控制主要的临床预后指标，已尝试在极少数研究中，这些因素的作用可能是不同的，在不同的文化背景。我们的调查旨在研究希腊儿童急性淋巴细胞白血病（ALL）预后的社会经济因素的独立作用。在7年期间（1996-2002年），293例急性淋巴细胞白血病事件被诊断和随访的四个儿童血液肿瘤单位，其中包括全国所有儿童急性淋巴细胞白血病病例的一半以上。在诊断时，记录了有关年龄、性别、母亲受教育程度、母亲婚姻状况、兄弟姐妹人数、居住地与治疗中心的距离、日托中心的出勤率和临床信息的信息。通过考克斯比例风险回归对数据进行建模，研究了这些因素对生存的影响。在调整临床预后因素后，目前未婚、教育水平低或远离治疗中心的母亲的子女的生存率往往较低（P值分别为0.02、0.14和0.08）。还有证据表明，两个因素是预测疾病的发生，即同胞的大小和日托中心的出勤率，也可以预测生存（P值分别为0.04和0.26）。总之，至少在某些社会文化背景下，社会经济因素可能会影响ALL的生存率。此外，有证据表明，可能通过调节群体免疫影响ALL发病率的因素也可能对该疾病具有预后意义。(C)2004年利平科特威廉姆斯威尔金斯。
An evaluation of the role of socioeconomic factors in the survival of children with leukaemia, controlling for major clinical prognostic indicators, has been attempted in very few studies and the role of these factors may be different in various cultural settings. Our investigation aims to study the independent role of socioeconomic factors on the prognosis of childhood acute lymphoblastic leukaemia (ALL) in Greece. During a 7-year period (1996-2002) 293 cases of incident ALL were diagnosed and followed up in four Childhood Haematology-Oncology Units, which covered over half of all childhood ALL cases nationwide. At the time of diagnosis, information concerning age, gender, maternal schooling, maternal marital status, sibship size, distance of residence from the treating centre, attendance of day care centre and clinical information was recorded. The influence of these factors on survival was studied by modelling the data through Cox's proportional-hazards regression. After adjustment for clinical prognostic factors, children of mothers who were not currently married, were of low educational level or were living far from the treating centre tended to have lower survival (P-values 0.02, 0.14 and 0.08, respectively). There was also evidence that two factors that are predictive of disease occurrence, that is sibship size and attendance of day care Centre, may also predict survival (P-values 0.04 and 0.26, respectively). In conclusion, socioeconomic factors are likely to influence survival from ALL at least in some sociocultural contexts. Moreover, there is evidence that factors that could affect incidence of ALL through modulation of herd immunity may also have prognostic implications for this disease. (C) 2004 Lippincott Williams Wilkins.