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儿童急性淋巴细胞白血病的生存率因种族和种族而异
Nina S Kadan-Lottick1, Kirsten K Ness, Smita Bhatia
1Division of Pediatric Hematology/Oncology, Yale University, New Haven, Conn, USA.
JAMA
|October 16, 2003
概括
儿童急性淋巴细胞白血病 (ALL) 存活率的种族和民族差异仍然存在. 黑人,西班牙裔和美洲原住民儿童面临的结果比白人和亚洲儿童更糟糕,需要进一步调查促成因素.
科学领域:
- 儿科瘤学 儿科瘤学
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 种族/种族对儿科急性淋巴细胞白血病 (ALL) 存活率的影响仍在争论中.
- 一些研究表明,少数民族儿童的生存率较低,而另一些研究则表明,现代治疗时代的治疗结果相当.
研究的目的:
- 为了进行一个大规模的,基于人口的种族/种族和美国ALL儿童的生存之间的关系的分析.
- 检查不同治疗期内不同种族和种族群体的生存趋势.
主要方法:
- 对4952起事件的分析:在1973年至1999年间诊断的19岁或更年轻的个体中,所有病例发生在1973年至1999年之间.
- 利用了来自国家癌症研究所的监测,流行病学和最终结果 (SEER) 计划的数据.
- 采用卡普兰-梅尔曲线和考克斯回归,根据治疗时期,诊断时的年龄和性别进行调整.
主要成果:
- 在连续治疗时期,整体5年生存率有所改善,但种族/民族差异仍然存在.
- 在1990-1999年期间,5年生存率为:白人 (84%),亚洲/太平洋岛民 (81%),黑人 (75%),美洲印第安人/阿拉斯加本土人 (72%) 和西班牙裔 (72%).
- 调整后的分析显示,与白人儿童相比,黑人 (1.50),西班牙裔 (1.83) 和美洲印第安人/阿拉斯加土著 (1.90) 儿童的死亡风险比率显著更高.
结论:
- 与白人和亚洲/太平洋岛民儿童相比,黑人,西班牙裔和美国印第安人/阿拉斯加土著儿童被诊断患有ALL存在重大生存劣势.
- 即使在当代治疗时代,这些差异也很明显.
- 进一步的研究至关重要,以确定导致这些结果差异的潜在社会,生物和药物动力学因素.
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