Risk of hospitalization among survivors of childhood and adolescent acute lymphoblastic leukemia compared to siblings and a general population sample |
| |
| Institution: | 1. Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, United States;2. Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT 84113, United States;3. Department of Institutional Research and Reporting, Salt Lake Community College, Salt Lake City, UT 84123, United States;4. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, United States;5. Department of Pediatric Hematology/Oncology, Salt Lake City Primary Children’s Hospital, UT 84132, United States;6. Division of Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, United States;1. University of Hawaii Cancer Center, Honolulu, HI, 9613, USA;2. CESP Inserm, Villejuif, France;3. Gustave Roussy, Villejuif, F-94805, France;4. Centre for Epidemiology and Biostatistics, Melbourne, VIC, Australia;5. Department of Clinical and Experimental Medicine, University of Pisa, Italy;1. Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, China;2. Group of Molecular Epidemiology & Cancer Precision Prevention (GMECPP), Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences (ZJAMS), Hangzhou, China;3. Xiamen Second Hospital, Xiamen, China;4. Jiashan Institute of Cancer Prevention and Treatment, Zhejiang Province, China;1. Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark;2. University Clinic for Innovative Patient Pathways, Silkeborg Hospital, Department of Clinical Medicine, Aarhus University, Falkevej 1-3, DK-8600 Silkeborg, Denmark;1. EPIUnit ? Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, no 135, 4050-600 Porto, Portugal;2. Registo Oncológico Regional do Norte (RORENO) ? Instituto Português de Oncologia do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;3. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal |
| |
| Abstract: | BackgroundAcute Lymphoblastic Leukemia (ALL) has a high survival rate, but cancer-related late effects in the early post-treatment years need documentation. Hospitalizations are an indicator of the burden of late effects. We identify rates and risk factors for hospitalization from five to ten years after diagnosis for childhood and adolescent ALL survivors compared to siblings and a matched population sample.Methods176 ALL survivors were diagnosed at ≤22 years between 1998 and 2008 and treated at an Intermountain Healthcare facility. The Utah Population Database identified siblings, an age- and sex-matched sample of the Utah population, and statewide inpatient hospital discharges. Sex- and birth year-adjusted Poisson models with Generalized Estimating Equations and robust standard errors calculated rates and rate ratios. Cox proportional hazards models identified demographic and clinical risk factors for hospitalizations among survivors.ResultsHospitalization rates for survivors (Rate:3.76, 95% CI = 2.22–6.36) were higher than siblings (Rate:2.69, 95% CI = 1.01–7.18) and the population sample (Rate:1.87, 95% CI = 1.13–3.09). Compared to siblings and population comparisons, rate ratios (RR) were significantly higher for survivors diagnosed between age 6 and 22 years (RR:2.87, 95% CI = 1.03–7.97 vs siblings; RR:2.66, 95% CI = 1.17–6.04 vs population comparisons). Rate ratios for diagnosis between 2004 and 2008 were significantly higher compared to the population sample (RR:4.29, 95% CI = 1.49, 12.32), but not siblings (RR:2.73, 95% CI = 0.54, 13.68). Survivors originally diagnosed with high-risk ALL did not have a significantly higher risk than siblings or population comparators. However, high-risk ALL survivors (Hazard ratio HR]:3.36, 95% CI = 1.33–8.45) and survivors diagnosed from 2004 to 2008 (HR:9.48, 95% CI = 1.93–46.59) had the highest risk compared to their survivor counterparts.ConclusionsFive to ten years after diagnosis is a sensitive time period for hospitalizations in the ALL population. Survivors of childhood ALL require better long-term surveillance. |
| |
| Keywords: | Survivors Health services research Epidemiologic research designs Siblings |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
