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Early deaths in pediatric acute leukemia: a population-based study

Sylvia Cheng1, Jason D Pole, Lillian Sung

  • 1Department of Paediatrics, University of Toronto , Toronto, Ontario , Canada.

Leukemia & Lymphoma
|October 5, 2013
PubMed

Insights

Early deaths in childhood acute leukemia are rare but linked to acute myeloid leukemia (AML) and older age. Infections caused 30% of these early fatalities in Ontario, Canada.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Epidemiology

Background:

  • Childhood acute leukemias, including acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), are significant health concerns.
  • Early mortality following diagnosis can impact overall survival rates and treatment strategies.

Purpose of the Study:

  • To determine the incidence and identify risk factors for early death (within 42 days of diagnosis) in children with ALL and AML in Ontario, Canada.
  • To inform future interventions aimed at reducing early mortality in pediatric leukemia patients.

Main Methods:

  • Population-based, retrospective cohort study utilizing the Pediatric Oncology Group of Ontario Networked Information System (POGONIS).
  • Inclusion criteria: Patients aged 18 years or younger diagnosed with ALL or AML between 1990 and 2010.
  • Analysis of early death rates, causes of death, and associated risk factors.

Main Results:

  • The overall early death rate was 1.7% (40/2357 children).
  • Patients with AML had a significantly higher early death rate (4.7%) compared to ALL (1.1%).
  • Acute myeloid leukemia and age 10 years or older at diagnosis were significant risk factors for early death; infection was a primary cause (30%).

Conclusions:

  • Early mortality in childhood acute leukemia is primarily associated with AML and older age at diagnosis.
  • Interventions targeting the initial treatment phase, particularly for AML and older children, are crucial for improving survival.
  • Reducing infection-related deaths during the early post-diagnosis period is a key area for intervention.

Keywords:
LeukemiaOntarioearly deathsmortalitypediatricpopulation-based

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