Measuring disparities in event-free survival among children with acute lymphoblastic leukemia in an academic institute in Oklahoma, 2005-2019.
Measuring disparities in event-free survival among children with acute lymphoblastic leukemia in an academic institute in Oklahoma, 2005-2019.
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DOI：
10.1016/j.canep.2022.102275
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发表时间：
2022-12
影响因子：
2.6
通讯作者：
McNall-Knapp, Rene Y.
中科院分区：
文献类型：
--
作者：
Janitz, Amanda E.;Barber, Rylee;Campbell, Janis E.;Xu, Chao;Pokala, Hanumantha R.;Blanchard, Jessica;McNall-Knapp, Rene Y.
关键词：
急性淋巴细胞性白血病(ALL)是最常见的儿童癌症类型。虽然白血病的治疗已经取得了成功，但关于服务不足人群中无事件生存率(EFS)差异的原因，可获得的信息较少。我们与一家学术机构的儿童医院合作，从该机构的癌症登记、州癌症登记和电子医疗记录中提取了2005-2019年20岁之前确诊的ALL(n=275)儿童的癌症诊断、治疗和结果的电子医疗记录。我们评估了1)种族/民族、2)到儿童医院的距离和3)EFS地区剥夺之间的关系，EFS的定义是从确诊到复发、死亡或研究结束的时间。我们使用Kaplan-Meier分析和对数等级检验来评估EFS的差异。我们使用COX比例风险模型进行多变量生存分析。大多数儿童被诊断为5岁以下ALL(45%)和B型前ALL(87%)。12%的儿童经历了复发，5%的儿童在诱导或缓解期间死亡。5年EFS为82%。与非西班牙裔(NH)白人儿童相比，非西班牙裔(NH)黑人儿童的EFS更差，尽管不准确(调整后的危险比：2.07，95%CI：0.80，5.38)。与最贫困地区相比，生活在贫困程度较高地区的儿童有更高的不良结局调整风险，尽管估计不准确(第二四分位数：1.51，第三四分位数：1.85，第四四分位数：1.62)。我们没有观察到到儿童医院的距离和EFS之间的联系。我们观察到NH黑人儿童和居住在高贫困地区的儿童的EFS较差，尽管估计值在统计学上没有显著意义。我们的下一步包括进一步评估农村和城市儿童的社会经济因素，以确定患有ALL和其他儿童癌症的儿童预后的差异。
Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. While there have been successes in the treatment of leukemia, less information is available on reasons for disparities in event-free survival (EFS) among underserved populations. We partnered with a children’s hospital at an academic institution to abstract data from the institution’s cancer registry, the state cancer registry, and electronic medical records on cancer diagnosis, treatment, and outcomes for children with ALL (n=275) diagnosed from 2005–2019 prior to age 20. We evaluated the relation between 1) race/ethnicity, 2) distance to the children’s hospital, and 3) area deprivation with EFS, defined as time from diagnosis to relapse, death, or the end of the study period. We evaluated differences in EFS using Kaplan-Meier analysis with the log-rank test. We used the Cox Proportional Hazards Model for multivariable survival analyses. Most children were diagnosed with ALL under five years of age (45%) and with Pre-B ALL (87%). Twelve percent of children experienced a relapse and 5% died during induction or remission. EFS at 5 years was 82%. Non-Hispanic (NH) Black children had worse, though imprecise, EFS compared to NH White children (Adjusted Hazard Ratio: 2.07, 95% CI: 0.80, 5.38). Children residing in areas with higher deprivation had a higher adjusted hazard of poor outcomes compared to the least deprived areas, though estimates were imprecise (2nd quartile HR: 1.51, 3rd quartile: 1.85, 4th quartile: 1.62). We observed no association between distance to the children’s hospital and EFS. We observed poorer EFS for NH Black children and children residing in areas with high deprivation, though the estimates were not statistically significant. Our next steps include further evaluating socioeconomic factors in both rural and urban children to identify disparities in outcomes for children with ALL and other childhood cancers.
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影响因子：
7.7
作者：
Textor, Johannes;van der Zander, Benito;Ellison, George T. H.
通讯作者：
Ellison, George T. H.
DOI：
10.1177/1043454215600155
发表时间：
2016-03
期刊：
Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
影响因子：
--
作者：
Lindley LC;Oyana TJ
通讯作者：
Oyana TJ
影响因子：
20.3
作者：
Borowitz, Michael J.;Wood, Brent L.;Larsen, Eric
通讯作者：
Larsen, Eric
影响因子：
2.4
作者：
Charalampopoulou, A;Petridou, E;Trichopoulos, D
通讯作者：
Trichopoulos, D
影响因子：
2.6
作者：
Marcotte EL;Spector LG;Mendes-de-Almeida DP;Nelson HH
通讯作者：
Nelson HH