Impact of age on the survival of pediatric leukemia: an analysis of 15083 children in the SEER database

Abstract

BACKGROUND & AIMSAge 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.METHODSIn 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.RESULTSThere 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.CONCLUSIONSAge at diagnosis remained to be a crucial determinant of the survival variability of pediatric leukemia patients.

Impact of marital status during diagnosis on cancer-caused specific survival in acute myeloid leukemia patients: a case-control and population-based study

“…Our study has identified multiple variables including, sex, age, AML subtype and adjuvant therapy as risk factors for AML mortality, based on Cox proportional hazard regression model analysis. This observation has also been verified independently by other studies [ 19 - 21 ]. Thus, subsequently we stratified patients from different marital status into subgroups based on these variables and studied their effect on cancer-CSS.…”

Vitamin D status in children with leukemia, its predictors, and association with outcome

“…The four seasons were defined as summer (June-August), fall (September-November), winter (December-February), and spring (March-May).The statistical analyses were performed for the whole cohort, and then, based on post hoc consideration, for the preschool children (≤6 years old) and the school children (>6 years old) separately. This grouping was based on three considerations: (1) on national guidelines for vitamin D supplementation, which have been changed several times since 1990, but children aged ≤6 years were more likely to receive supplementation24,25 ; (2) on differences in activities and lifestyle in preschool and school children; and (3) on the knowledge that age itself has a prognostic value in children with leukemia 26,27. The associationbetween serum 25(OH)D and PTH levels was analyzed using simple linear regression.…”

A Comparison of the Clinical Outcomes of Haploidentical Transplantation and Other Graft Sources in Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis

“…The treatment outcomes of pediatric acute lymphoblastic leukemia (ALL) have improved markedly over the last decade to reach a 5-year disease-free survival rate of 90% 1 . In adult ALL patients, however, the rate is 50%-60% even if they are treated with the pediatric-inspired regimen 2,3 .…”