Impact of age on the survival of pediatric leukemia: an analysis of 15083 children in the SEER database.
Impact of age on the survival of pediatric leukemia: an analysis of 15083 children in the SEER database.
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年龄对儿童白血病生存的影响：对 SEER 数据库中 15083 名儿童的分析。
DOI：
10.18632/oncotarget.11765
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发表时间：
2016-12-13
期刊：
影响因子：
--
通讯作者：
Fang Y
中科院分区：
文献类型：
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作者：
Wang Y;Huang J;Rong L;Wu P;Kang M;Zhang X;Lu Q;Fang Y
诊断时的年龄是预测儿童白血病预后的关键因素，尤其是在生存评估方面。在这项研究中，我们的目的是评估这种预后因素的影响，如年龄在儿童白血病儿童。本研究分析了1988-2013年期间监测、流行病学和最终结果计划登记的白血病儿童。所有患者根据诊断时的年龄分为5组（<1岁，1-4岁，5-9岁，10-15岁，>15岁）。Kaplan-Meier和多变量考克斯回归模型用于评估白血病生存结局和危险因素。不同诊断年龄的儿童白血病生存率存在显著差异，包括ALL、AML和CML亚型。根据各组的生存曲线，ALL患儿在1-4岁时诊断的儿童中生存率达到峰值，在较大年龄诊断的儿童中生存率稳步下降。婴儿（<1岁）在ALL或AML儿童中的存活率最低。然而，儿童（1-4岁）患有CML的预后最差。对诊断时年龄的影响进行分层分析，证实其为儿童白血病预后的独立预测因素。诊断时的年龄仍然是儿童白血病患者生存变异性的一个关键决定因素。
Age at diagnosis is a key factor for predicting the prognosis of pediatric leukemia especially regarding the survivorship assessment. In this study, we aimed to assess the impact of this prognostic factor such as age in children with pediatric leukemia. In this study, Surveillance, Epidemiology, and End Results Program-registered children with leukemia during 1988-2013 were analyzed. All patients were divided into five groups according to the age at the time of diagnosis (<1, 1-4, 5-9, 10-15, >15 years old). Kaplan-Meier and multivariable Cox regression models were used to evaluate leukemia survival outcomes and risk factors. There was significant variability in pediatric leukemia survival by age at diagnosis including ALL, AML and CML subtypes. According to the survival curves in each group, survival rate were peaked among children diagnosed at 1–4 years and steadily declined among those diagnosed at older ages in children with ALL. Infants (<1 year) had the lowest survivorship in children with either ALL or AML. However, children (1-4 years) harbored the worst prognosis suffering from CML. A stratified analysis of the effect of age at diagnosis was validated as independent predictors for the prognosis of pediatric leukemia. Age at diagnosis remained to be a crucial determinant of the survival variability of pediatric leukemia patients.